PHYLLIS H. PENG (NPI# 1770633596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770633596 |
Entity Type | Individual |
Full Name | PHYLLIS H. PENG |
Credential | MD |
Practice Address |
4601 Dale Rd Modesto CA 95356-9718 |
Mailing Address |
1800 Harrison St Fl 7 Oakland CA 94612-3429 |
Practice Telephone | 2095571000 |
Mailing Telephone | 5106256262 |
Enumeration Date | 2007-01-12 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Y00000X | Otolaryngology | A94698 | CA | Allopathic & Osteopathic Physicians |
Street Address |
4601 DALE RD |
City | MODESTO |
State | CA |
Zip Code | 95356-9718 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912998311 | Stephen Matthew Willey | Physical Therapist | 4601 Dale Rd, Modesto, CA 95356 | 2005-11-03 |
1760098263 | Paola Ramirez | Behavior Technician | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-09-20 |
1538772678 | Roy Choi | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-08-28 |
1730797499 | Donna Cruz | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-07-20 |
1538777487 | Kyle Wesley Hopson | Physical Therapist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-07-16 |
1376176313 | Su Jin Yeo | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-02-18 |
1972135580 | Tran Huyen Smernes | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2020-02-11 |
1740827534 | Evelyn Kwong | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2019-11-29 |
1467000463 | Oanh Hoang Nguyen Phan | Nurse Practitioner | 4601 Dale Rd, Modesto, CA 95356-9718 | 2019-09-03 |
1598311227 | Janine Grace Lastimosa Tennant | Pharmacist | 4601 Dale Rd, Modesto, CA 95356-9718 | 2019-08-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649809021 | Amelia E Delgadillo | Licensed Vocational Nurse | 501 Triangle Rd, Modesto, CA 95356 | 2020-04-07 |
1689220279 | Meagan Veneman | Physical Medicine & Rehabilitation | 125 Hogue Rd, Modesto, CA 95356 | 2019-08-10 |
1497131213 | Hermes Guardian Transport | Non-emergency Medical Transport (VAN) | 4221 Erin Way, Modesto, CA 95356 | 2015-08-04 |
1811373640 | Melissa Ruiz | Marriage & Family Therapist | 5815 Stoddard Rd Suite 600, Modesto, CA 95356 | 2015-08-04 |
1922242866 | Lifecare Solutions Inc | Durable Medical Equipment & Medical Supplies | 500 Glass Ln Ste H, Modesto, CA 95356 | 2009-04-22 |
1659541647 | Ashley Allison Streeter | Dentist | 556 Lyell Dr, Modesto, CA 95356 | 2008-03-05 |
1265636013 | Margaret Kathleen Grisell | Orthopaedic Surgery | 4601 Dale Ave, Kaiser Modesto Medical Center, Orthopedic Surgery, Modesto, CA 95356 | 2007-06-14 |
1841412111 | Bobby Gene Boswell | Specialist/Technologist | 3908 Vintage Cove, Modesto, CA 95356 | 2007-05-03 |
1598892861 | Merritt Radiological Medical Group Inc | Radiology | 526 Charity Way, Modesto, CA 95356 | 2007-02-27 |
1396871091 | Michael Steven Beck | Social Worker | 4640 Spyres Way, Building B, Suite 7, Modesto, CA 95356 | 2007-02-26 |
Find all providers in zip 95356 |
Taxonomy Code | 207Y00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Otolaryngology |
An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013073766 | Douglas M Phan | Otolaryngology | 1541 Florida Ave Ste 304, Modesto, CA 95350-4439 | 2006-12-28 |
1477810323 | First Choice Physician Partners | Otolaryngology | 1541 Florida Ave, Ste 304, Modesto, CA 95350-4429 | 2012-04-17 |
1982782876 | Vijay C.s. Bais | Otolaryngology | 4601 Dale Rd, Modesto, CA 95356-9718 | 2006-11-01 |
1639257124 | Christopher S. Whang | Otolaryngology | 4601 Dale Rd, Modesto, CA 95356-9718 | 2006-11-01 |
1457439945 | Mark J. Bitgood | Otolaryngology | 4601 Dale Rd, Modesto, CA 95356-9718 | 2006-11-01 |
1982630901 | Aren D Francis | Otolaryngology | 600 Coffee Rd, Modesto, CA 95355-4201 | 2006-06-23 |
1851330336 | Robert L Cotton | Otolaryngology | 600 Coffee Rd, Modesto, CA 95355-4201 | 2006-06-06 |
1750334116 | Charles Alan Yates | Otolaryngology | 1510 Florida Ave, Modesto, CA 95350-4437 | 2006-05-18 |
1427007798 | Kenneth W Mak | Otolaryngology | 1541 Florida Ave, 301, Modesto, CA 95350-4429 | 2006-05-06 |
1619934056 | Charles R Suntra | Otolaryngology | 600 Coffee Rd, Modesto, CA 95355-4201 | 2006-04-28 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.