Peninsula Medical Group

Primary specialty

SpecialistTaxonomy code 174400000X

License

A440070 Issued in CA

Legal business name

PENINSULA MEDICAL GROUP

Practice address

1720 El Camino Real
Ste 145
Burlingame, CA 94010-3224

Phone

(650) 692-8804

Fax

(650) 692-8805

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Spencer Timothy Lowe, M.D.NPI 1134213572

Title

Medical Director

Phone

(650) 692-8804

Specialties & licenses 1

Addresses

Other names 1

• none Other name

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.

• Spencer T Lowe, M.D.

  • Rheumatology Physician
  • Burlingame, CA
  • NPI 1134213572
  NPD (past) Authorized official
• Cecilia W Wan, M.D.

  • Internal Medicine Physician
  • Burlingame, CA
  • NPI 1780779108
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1376671206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 EL CAMINO REAL",
            "address_2": "STE 145",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103224",
            "telephone_number": "650-692-8804",
            "fax_number": "650-692-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 EL CAMINO REAL",
            "address_2": "STE 145",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103224",
            "telephone_number": "650-692-8804",
            "fax_number": "650-692-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "650-692-8804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A440070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "none",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Peninsula Child and Family Therapy Inc
• Peninsula Dermatology Medical Group Inc
• Peninsula Endoscopy Center LLC
• Peninsula Heights Diagnostic Laboratories, Inc.
• Peninsula Hospitalist Associates, Inc.
• Peninsula Neurological Associates
• Peninsula Ophthalmology Group, Inc.
• Peninsula Pathologists Medical Group Inc.
• Peninsula Pediatric Med GRP Inc
• Peninsula Plastic Surgery Medical Group Inc

• Specialist in Burlingame, CA
• Providers in Burlingame, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.