NPIMap

Organization Active NPI

Fairview Hospital

  • Primary Care Clinic/Center
  • Daly City, CA
National Provider Identifier
1407989759
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
33899 Issued in CA
Legal business name
FAIRVIEW HOSPITAL
Practice address
901 Campus Dr
Suite 210
Daly City, CA 94015-4900
Phone
(650) 994-3000
Fax
(650) 994-3004
NPI assigned
Mar 14, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Merlita Borja EvangelistaNPI 1710029558
Title
Pediatrician
Phone
(440) 779-1615

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 33899 CA Primary

Addresses

Primary practice location

901 Campus Dr
Suite 210
Daly City, CA 94015-4900

Mailing address

22338 Sharon LN
Fairview Park, OH 44126-2543
Phone (440) 779-1615

National Provider Directory

National Provider Directory
Tax ID family
Fairview General Hosp23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

901 Campus Dr
Ste 210
Daly City, CA 94015
Phone (503) 821-7002

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407989759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22338 SHARON LN",
            "city": "FAIRVIEW PARK",
            "state": "OH",
            "postal_code": "441262543",
            "telephone_number": "440-779-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DR",
            "address_2": "SUITE 210",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154900",
            "telephone_number": "650-994-3000",
            "fax_number": "650-994-3004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRVIEW HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EVANGELISTA",
        "authorized_official_first_name": "MERLITA",
        "authorized_official_middle_name": "BORJA",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "440-779-1615",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "33899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.