PHYLLIS H. PENG


Address: 4601 Dale Rd, Modesto, CA 95356-9718
Phone: 2095571000

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology A94698 CA Allopathic & Osteopathic Physicians

Office Location

Street Address 4601 DALE RD
City MODESTO
State CA
Zip Code 95356-9718

Providers in the same location

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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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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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Competitor

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City MODESTO
Zip Code 95356

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Dataset Information

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.

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