Peninsula Biomedical, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PENINSULA BIOMEDICAL, INC.

Doing business as

Peninsula Medical, Inc.

Practice address

108 Whispering Pines Dr
Suite 115
Scotts Valley, CA 95066-4792

Phone

(831) 430-9066

Fax

(831) 430-9068

NPI assigned

Jan 16, 2007

Last updated

Jul 19, 2017By 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. Anndee Hafner

Title

General Manager

Phone

(831) 430-9066

Specialties & licenses 2

Addresses

Other identifiers 8

Other names 1

• Peninsula Medical, Inc. Doing business as

Locations

Practitioners 1

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.

• Tony R Reid, M.D

  • Internal Medicine Physician
  • La Jolla, CA
  • NPI 1346323904
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500422400000",
    "number": "1386795011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66149",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950676149",
            "telephone_number": "831-430-9066",
            "fax_number": "831-430-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 WHISPERING PINES DR",
            "address_2": "SUITE 115",
            "city": "SCOTTS VALLEY",
            "state": "CA",
            "postal_code": "950664792",
            "telephone_number": "831-430-9066",
            "fax_number": "831-430-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA BIOMEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2017-07-19",
        "status": "A",
        "authorized_official_last_name": "HAFNER",
        "authorized_official_first_name": "ANNDEE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "831-430-9066",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "2676",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8129631-00",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2107491",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "82712600",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9102475",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29401372",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9048612",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4549517",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807375000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peninsula Medical, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danica Parungao
• Christine Pascoe
• Alisha Patel, ATC
• Ashzra Pedersen, DNP, RN, FNP-C, AGNP
• Peninsula Biomedical, Inc. (Peninsula Medical, Inc.)
• Melissa Perez
• Andrew Pflueger, LMFT
• Tracy Pham, RPH
• Lauren Phillips
• Amelia Rene Phinn, RN, BN, CLEC

• Durable Medical Equipment & Medical Supplies in Scotts Valley, CA
• Providers in Scotts Valley, CA by specialty
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.