San Mateo Spine Center a Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SAN MATEO SPINE CENTER A MEDICAL CORPORATION

Practice address

101 S San Mateo Dr Ste 301
San Mateo, CA 94401-3844

Phone

(650) 558-1802

NPI assigned

Oct 29, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Denise Kubick

Title

Office Manager

Phone

(650) 685-9940

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yung Chen, MD

  • Physical Medicine & Rehabilitation Physician
  • San Mateo, CA
  • NPI 1386601623
  Medicare reassignment NPD
• James Chessing, PHD

  • Clinical Psychologist
  • San Mateo, CA
  • NPI 1326142407
  NPD (past)
• Kevin Dean Morse, M.D.

  • Psychiatry Physician
  • San Jose, CA
  • NPI 1255478947
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1043463441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S SAN MATEO DRIVE SUITE 301",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94401",
            "telephone_number": "650-558-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S SAN MATEO DR STE 301",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013844",
            "telephone_number": "650-558-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN MATEO SPINE CENTER A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-29",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "KUBICK",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "650-685-9940"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Mateo Medical Centerr
• San Mateo Orthopedic Medical Group Inc
• San Mateo Physical Therapy Center
• San Mateo Psychological Services
• San Mateo Rheumatology Inc.
• San Mateo Surgery Center
• San Mateo Surgery Center LLC
• San Mateo Union High School District
• San Mateo-Foster City School District
• Viridiana G. Sanchez Bueno

• Specialist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.