NPIMap

Organization Active NPI

Crystal Springs Surgical Associates, a Medical Group, Inc.

  • Surgery Physician
  • San Mateo, CA
National Provider Identifier
1376631762
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G079786 Issued in CA
Legal business name
CRYSTAL SPRINGS SURGICAL ASSOCIATES, A MEDICAL GROUP, INC.
Practice address
101 S San Mateo Dr
Suite 302
San Mateo, CA 94401-3819
Phone
(650) 685-2959
NPI assigned
Oct 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Authorized official

Name
Dr. John J Feng, M.D.NPI 1275625832
Title
President/Owner
Phone
(650) 685-2959

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X G079786 CA Primary

Addresses

Primary practice location

101 S San Mateo Dr
Suite 302
San Mateo, CA 94401-3819

Mailing address

101 S San Mateo Dr
Suite 302
San Mateo, CA 94401-3819
Phone (650) 685-2959

National Provider Directory

National Provider Directory

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": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1376631762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S SAN MATEO DR",
            "address_2": "SUITE 302",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013819",
            "telephone_number": "650-685-2959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S SAN MATEO DR",
            "address_2": "SUITE 302",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013819",
            "telephone_number": "650-685-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL SPRINGS SURGICAL ASSOCIATES, A MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "FENG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "650-685-2959",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "G079786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.