Permanente Medical Group Inc
Organization Active NPI Internal Medicine Physician · Santa Clara, CA
NPI 1073606299 · NPPES record last updated Nov 12, 2024
Key facts
- NPI
- 1073606299
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- PERMANENTE MEDICAL GROUP INC
- Practice address
- 710 Lawrence Expressway
Santa Clara, CA 95051-5173 - Phone
- (408) 851-1000
- NPI assigned
- Oct 2, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- PERMANENTE MEDICAL GROUP, INC.
Authorized official
- Name
- Ms. Patricia T West
- Title
- Chief Financial Officer
- Phone
- (510) 295-7207
Other NPIs on the same Medicare enrollment 5
Other NPIs with the same Medicare PAC ID 1
Practitioners 21,333
-
Alexander Garcia Abad, M.P.T.
-
Alvin Joseph Untalan Abad, FNP-C
-
Adan Abarca, MD
-
Fakhar Abbas, MD
-
Steven F. Abboud, MD
-
Triveni Abburi, M.D.
-
Rizwana Abdullah, MD
-
Jimmark V Abenojar, M.D.
-
Olana Aberra, MD
-
Rola Aboueljoud, DPT
-
Adriana Abril, MFT
-
Noman Absar, MD
-
Fatima Flores Abutin, M.D
-
Karen Jennifer Abuzahra, PSYD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031104000710 | CA | Part B Supplier - Clinic/Group Practice | 8921910225 |
Receives reassigned benefits from 20,648 practitioners 5 other NPIs on this enrollment |
National Provider Directory
- Part of
- Perm Med GRP Inc
Locations
750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131
10050 N Wolfe Rd
Ste SW1190
Cupertino, CA 95014
Phone (408) 236-6160
9201 Big Horn Blvd
Elk Grove, CA 95758
Phone (916) 478-5000
2155 Iron Point Rd
Folsom, CA 95630
Phone (916) 817-5000
1630 E Shaw Ave
Ste 124
Fresno, CA 93710
Phone (559) 448-5633
1777 W Yosemite Ave
Manteca, CA 95337
Phone (209) 825-3555
1789 W Yosemite Ave
Manteca, CA 95337
Phone (209) 825-3700
565 Castro St
Mountain View, CA 94041
Phone (650) 903-2850
3701 Broadway
Oakland, CA 94611
Phone (510) 752-4148
3030 Webster St
Oakland, CA 94609
Phone (510) 250-8000
3900 Broadway
Oakland, CA 94611
Phone (510) 752-1075
3772 Howe St
Piedmont, CA 94611
Phone (510) 752-1235
3825 Hopyard Rd
Ste 140
Pleasanton, CA 94588
Phone (925) 847-5051
1190 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015
1643 Eureka Rd
Roseville, CA 95661
Phone (916) 771-7611
2120 Professional Dr
Roseville, CA 95661
Phone (916) 631-3010
8247 E Stockton Blvd
Sacramento, CA 95828
Phone (916) 478-5000
906 G St
Sacramento, CA 95814
Phone (916) 341-3000
801 Traeger Ave
Ste 304
San Bruno, CA 94066
Phone (650) 438-2158
1600 Owens St
San Francisco, CA 94158
Phone (415) 833-2200
3559 Round Barn Blvd
Santa Rosa, CA 95403
Phone (707) 571-3931
941 Merchant St
Vacaville, CA 95688
Phone (707) 447-8191
1515 Newell Ave
Walnut Creek, CA 94596
Phone (925) 295-5447
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician |
207L00000X | |||
| Dermatology Physician |
207N00000X | |||
| Emergency Medicine Physician |
207P00000X | |||
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Obstetrics & Gynecology Physician |
207V00000X | |||
| Ophthalmology Physician |
207W00000X | |||
| Orthopaedic Surgery Physician |
207X00000X | |||
| Otolaryngology Physician |
207Y00000X | |||
| Anatomic Pathology & Clinical Pathology Physician |
207ZP0102X | |||
| Pediatrics Physician |
208000000X | |||
| Physical Medicine & Rehabilitation Physician |
208100000X | |||
| Psychiatry Physician |
2084P0800X | |||
| Diagnostic Radiology Physician |
2085R0202X | |||
| Surgery Physician |
208600000X |
Addresses
Primary practice location
710 Lawrence Expressway
Santa Clara, CA 95051-5173
Mailing address
5820 Owens Dr. Building E, 2ND Floor
Pleasanton, CA 94588-3900
Phone (925) 924-6840
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR001572T | Medicaid | CA | |
| ZZZ74979Z | Medicaid | CA | |
| GR001572U | Medicaid | CA | |
| GROO1572P | Medicaid | CA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) |
Other providers in Santa Clara, CA
- Alicia Perez
- Amanda Tatiana Perez
- Claudia Perez
- Karalyn Perez
- Maria Fernanda Perez
- Brianna K Perry
- Nalini Persaud
- Peter Badua Pac
- Matthew Wyatt Peters
- John Peterson
All providers in Santa Clara, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.