NPIMap

Organization Active NPI

North East Medical Services

  • Federally Qualified Health Center (FQHC)
  • Daly City, CA
National Provider Identifier
1265217616
Registry record updated Aug 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH EAST MEDICAL SERVICES
Practice address
1850 Sullivan Ave Ste 190
Daly City, CA 94015-2230
Phone
(650) 550-3923
NPI assigned
Aug 25, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2023

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

Authorized official

Name
Eddie W Chan
Title
President & Ceo
Phone
(415) 391-9686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

1850 Sullivan Ave Ste 190
Daly City, CA 94015-2230

Mailing address

2171 Junipero Serra Blvd Ste 700
Daly City, CA 94014-1982
Phone (415) 391-9686

Other names 1

  • North East Medical Services -Sullivan Suite 190 Other name

National Provider Directory

National Provider Directory
Tax ID family
North East Medical Services57 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1850 Sullivan Ave
Ste 190
Daly City, CA 94015
Phone (650) 550-3923

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1265217616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 JUNIPERO SERRA BLVD STE 700",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940141982",
            "telephone_number": "415-391-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE STE 190",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152230",
            "telephone_number": "650-550-3923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EAST MEDICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "415-391-9686"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North East Medical Services -Sullivan Suite 190",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.