San Francisco Dermatopathology Institute Professional Corporation

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF00345457 Issued in CA

Legal business name

SAN FRANCISCO DERMATOPATHOLOGY INSTITUTE PROFESSIONAL CORPORATION

Practice address

1618 Sullivan Ave.
Suite 105
Daly City, CA 94015-1968

Phone

(650) 756-5500

NPI assigned

Dec 18, 2013

Last updated

Dec 18, 2013By 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

Dr. Gary W OliverNPI 1073599411

Title

Director

Phone

(415) 413-6100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Gary W Oliver, MD

  • Dermatopathology (Pathology) Physician
  • Daly City, CA
  • NPI 1073599411
  Medicare reassignment NPD Authorized official
• Pente NG, RN, MSN, FNP-C

  • Family Nurse Practitioner
  • Brentwood, CA
  • NPI 1720619885
  Medicare reassignment NPD

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387324800000",
    "number": "1366863318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 SULLIVAN AVE.",
            "address_2": "SUITE 105",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151968",
            "telephone_number": "650-756-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 SULLIVAN AVE.",
            "address_2": "SUITE 105",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151968",
            "telephone_number": "650-756-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN FRANCISCO DERMATOPATHOLOGY INSTITUTE PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-18",
        "last_updated": "2013-12-18",
        "status": "A",
        "authorized_official_last_name": "OLIVER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "415-413-6100",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF00345457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Navya Sakhamuri, MD
• Jeanne Hansen Salisbury, RN
• Dania Salman
• Goldie Samera, RN
• Michael C. Samn, MD
• San Francisco Peninsula Cardiovascular Medical GRP Inc
• San Mateo County (North County Mental Health)
• San Mateo County Medical Center
• San Mateo County Medical Center
• San Mateo Medical Center

• Clinical Medical Laboratory in Daly City, CA
• Providers in Daly City, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.