Specialty Care and Surgery Center

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

G6256 Issued in CA

Legal business name

SPECIALTY CARE AND SURGERY CENTER

Practice address

5685 Main St
Kelseyville, CA 95451-8945

Phone

(707) 279-8733

Fax

(707) 279-8731

NPI assigned

Feb 23, 2007

Last updated

Jul 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Paula R Dhanda, MDNPI 1316972425

Title

Physician

Phone

(707) 279-8733

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Specialty Care and Surgery Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Specialty Care and Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Kelseyville, CA
  • NPI 1184844607
  NPD tax ID
• Specialty Care and Surgery Center

  • Gynecology Physician
  • Kelseyville, CA
  • NPI 1700276003
  NPD tax ID

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Paula R Dhanda

  • Gynecology Physician
  • Kelseyville, CA
  • NPI 1316972425
  Medicare reassignment NPD Authorized official
• Lorena A Watson, FNP

  • Family Nurse Practitioner
  • Lakeport, CA
  • NPI 1942558721
  Medicare reassignment NPD
• John Clarke

  • Anesthesiology Physician
  • Clearlake, CA
  • NPI 1053329359
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436313600000",
    "number": "1073648630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5685 MAIN ST",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518945",
            "telephone_number": "707-279-8733",
            "fax_number": "707-279-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5685 MAIN ST",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518945",
            "telephone_number": "707-279-8733",
            "fax_number": "707-279-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY CARE AND SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2015-07-08",
        "status": "A",
        "authorized_official_last_name": "DHANDA",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "707-279-8733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "G6256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G625260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth a Stewart (Kelseyville Pharmacy)
• Mark Seelig, PHD, NAT DOCTOR
• Olga Segal, MD
• Bradley James Smith, PT
• Lori Smith
• Specialty Care and Surgery Center
• Specialty Care and Surgery Center
• Joseph William Spickler, M.D.
• Surin Srikureja, DO
• Victoria Thiesemann, MS, CCC-SLP

• Gynecology Physician in Kelseyville, CA
• Providers in Kelseyville, CA by specialty
• Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.