Organization Active NPI

LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
National Provider Identifier
1417907940
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Children's HospitalTaxonomy code 282NC2000X
Legal business name
LPCH MEDICAL GROUP DIV OF LUCILE
Practice address
725 Welch Rd
Palo Alto, CA 94304-1601
Phone
(650) 498-6762
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Authorized official

Name
Dana Jean Haering
Title
Cfo
Phone
(650) 721-2222

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Children's Hospital 282NC2000X Primary

Addresses

Primary practice location

725 Welch Rd
Palo Alto, CA 94304-1601

Mailing address

4700 Bohannon Dr
MC 5530
Menlo Park, CA 94025-1031

Other names 1

  • Lucile Salter Packard Children's Hospital at Stanford Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061113000232 CA Part B Supplier - Clinic/Group Practice 0840298543 Receives reassigned benefits from 3,863 practitioners
Practice locations: Palo Alto, CA

National Provider Directory

National Provider Directory

Locations (25 of 223)

3700 Sunset Ln
Ste 6
Antioch, CA 94509
Phone (925) 755-8500

824 Bay Ave
Ste 70
Capitola, CA 95010
Phone (831) 464-6200

20126 Stanton Ave
Ste 201
Castro Valley, CA 94546
Phone (510) 237-6320

20126 Stanton Ave
Ste 200
Castro Valley, CA 94546
Phone (510) 881-4210

9000 Crow Canyon Rd
Ste S220
Danville, CA 94506

11875 Dublin Blvd
#B125
Dublin, CA 94568

6121 Hollis St
Ste 2
Emeryville, CA 94608
Phone (510) 587-9600

6121 Hollis St
Ste 900
Emeryville, CA 94608
Phone (510) 974-2800

7710 N Fresno St
Ste 102
Fresno, CA 93720
Phone (559) 437-9100

27212 Calaroga Ave
Hayward, CA 94545
Phone (510) 783-5532

1134 Murrieta Blvd
#A
Livermore, CA 94550

1134 Murrieta Blvd
Ste A
Livermore, CA 94550
Phone (925) 449-7795

960 N San Antonio Rd
Los Altos, CA 94022
Phone (650) 724-8844

16795 Lark Ave
Los Gatos, CA 95032

14651 S Bascom Ave
Ste 200
Los Gatos, CA 95032
Phone (408) 356-2154

718 University Ave
Los Gatos, CA 95032
Phone (408) 354-2114

14777 Los Gatos Blvd
Los Gatos, CA 95032

16795 Lark Ave
Ste 230
Los Gatos, CA 95032
Phone (408) 395-6837

14601 S Bascom Ave
Ste 112
Los Gatos, CA 95032

14651 S Bascom Ave
Ste 112
Los Gatos, CA 95032
Phone (408) 356-9300

777 Knowles Dr
Los Gatos, CA 95032

14651 S Bascom Ave
Ste 110
Los Gatos, CA 95032
Phone (408) 356-8681

4700 Bohannon Dr
#5530
Menlo Park, CA 94025

61 Camino Alto
Ste 103
Mill Valley, CA 94941
Phone (415) 383-0918

1401 Spanos Ct
Ste 233
Modesto, CA 95355

Practitioners & affiliated clinicians

Practitioners 4,401

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 4,401

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1417907940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 BOHANNON DR",
            "address_2": "MC 5530",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-498-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LPCH MEDICAL GROUP DIV OF LUCILE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A",
        "authorized_official_last_name": "HAERING",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "650-721-2222"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lucile Salter Packard Children's Hospital at Stanford",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lucile Salter Packard Children's Hospital at Stanford",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.