Wavecrest Medicine, Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

WAVECREST MEDICINE, INC.

Practice address

1850 Sullivan Ave
Suite 320
Daly City, CA 94015-2221

Phone

(650) 985-0530

Fax

(650) 985-0535

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Kris C Kealey, MD

Title

Ceo

Phone

(650) 985-0530

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Naira Rose Sanoyan, M.D.

  • Internal Medicine Physician
  • Palm Springs, CA
  • NPI 1386614394
  NPD
• John O Lai, M.D.

  • Internal Medicine Physician
  • Daly City, CA
  • NPI 1457398406
  NPD (past)
• Akhila Lalita Venugopal, M.D.

  • Internal Medicine Physician
  • Madison, WI
  • NPI 1831309079
  NPD (past)

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1619087988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "SUITE 320",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152221",
            "telephone_number": "650-985-0530",
            "fax_number": "650-985-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE",
            "address_2": "SUITE 320",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152221",
            "telephone_number": "650-985-0530",
            "fax_number": "650-985-0535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAVECREST MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "KEALEY",
        "authorized_official_first_name": "KRIS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-985-0530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0101480",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip Ward
• Jacqueline Warner, MFT
• Washington Dental Care
• Mikuela Washington
• Andrew Watson
• Truman Wayne
• Jess Webb
• Kimberly Lynn Webb, AU.D.
• Molly Webb
• Robert William Weber, MD

• Primary Care Clinic/Center in Daly City, CA
• Providers in Daly City, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; 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.