Peninsula Dialysis Access Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PENINSULA DIALYSIS ACCESS CENTER

Practice address

91 Westborough Blvd Ste 1010
South San Francisco, CA 94080-3196

Phone

(408) 410-9266

Fax

(408) 877-3786

NPI assigned

Oct 25, 2024

Last updated

Dec 30, 2024By 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

Mrs. Chris McMahon

Title

Vice President

Phone

(408) 410-9266

Specialties & licenses 1

Addresses

Other names 1

• Peninsula Dialysis Access, LLC Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346062999. Details of each certification follow.

• CCN 55C0001196 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 55C0001196

Legal name

PENINSULA DIALYSIS ACCESS CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Aug 14, 2025

Last certification

Jul 30, 2025

Ownership / control type

Proprietary

Facility address

91 Westborough Blvd., Suite 1010
South San Francisco, CA 94080

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.

• Christian Cosca Cruz, MD

  • Nephrology Physician
  • Daly City, CA
  • NPI 1023182227
  NPD
• Fred Y H Lui, M.D.

  • Nephrology Physician
  • San Francisco, CA
  • NPI 1265461644
  NPD
• Daniel Angeli, MD

  • Nephrology Physician
  • Daly City, CA
  • NPI 1326417916
  NPD (past)

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1346062999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 WESTBOROUGH BLVD STE 1010",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803196",
            "telephone_number": "408-410-9266",
            "fax_number": "408-877-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 WESTBOROUGH BLVD STE 1010",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803196",
            "telephone_number": "408-410-9266",
            "fax_number": "408-877-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA DIALYSIS ACCESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-25",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "408-410-9266",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peninsula Dialysis Access, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Derek Paw, PHARM D.
• Dustin Paz, MD
• Keon Pearson, MD
• Danilo Pedroso
• Yessenia Patricia Pena Ruiz
• Peninsula Dialysis Access, LLC
• Peninsula Pathologists Medical Group
• Peninsula Sleep Lab
• Rumany Chang Penn, PHARM.D.
• Catherine D. Pepper, LCSW

• Ambulatory Surgical Clinic/Center in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.