After Hour Pediatrics Urgent Care Clinic, a Medical Corporation
Organization Active NPI Urgent Care Clinic/Center · San Mateo, CA
NPI 1417009705 · NPPES record last updated Jan 26, 2021
Key facts
- NPI
- 1417009705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urgent Care Clinic/Center 261QU0200X
- Legal business name
- AFTER HOUR PEDIATRICS URGENT CARE CLINIC, A MEDICAL CORPORATION
- Practice address
- 210 Baldwin Ave
San Mateo, CA 94401-3915 - Phone
- (510) 579-6581
- Fax
- (650) 579-7851
- NPI assigned
- Jan 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Connie Streifinger Kniveton, MD
- Title
- Medical Director
- Phone
- (650) 579-6581
Practitioners 2
-
Martin Andrew Fung, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2050073 | After Hour Pediatrics Urgent Care CLNC, a Med Corp | Certificate of waiver | Nov 18, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210128000188 | CA | Part B Supplier - Clinic/Group Practice | 6507270808 |
Receives reassigned benefits from 1 practitioner Practice locations: San Mateo, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urgent Care Clinic/Center | 261QU0200X | Yes |
Addresses
Primary practice location
210 Baldwin Ave
San Mateo, CA 94401-3915
Mailing address
210 Baldwin Ave
San Mateo, CA 94401-3915
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ61931Z | Other | CA | BLUE SHIELD ID |
Other names
- After Hour Pediatrics Urgent Care Clinic
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All providers in San Mateo, CA · Urgent Care Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.