NPIMap

Organization Active NPI

Mills-Peninsula Medical Group

  • General Practice Physician
  • Burlingame, CA
National Provider Identifier
1639384274
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
MILLS-PENINSULA MEDICAL GROUP
Practice address
577 Airport Blvd
Suite 300
Burlingame, CA 94010-2020
Phone
(650) 240-8000
Fax
(650) 240-0953
NPI assigned
May 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
Sharon Katz, RN,ND
Title
VP of Medical Management Privacy of
Phone
(650) 240-8053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

577 Airport Blvd
Suite 300
Burlingame, CA 94010-2020

Mailing address

577 Airport Blvd
Suite 300
Burlingame, CA 94010-2020
Phone (650) 240-8000

National Provider Directory

National Provider Directory

Locations

577 Airport Blvd
Ste 300
Burlingame, CA 94010
Phone (650) 240-8198

Practitioners & affiliated clinicians

Practitioners 3

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": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1639384274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 AIRPORT BLVD",
            "address_2": "SUITE 300",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940102020",
            "telephone_number": "650-240-8000",
            "fax_number": "650-240-0953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 AIRPORT BLVD",
            "address_2": "SUITE 300",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940102020",
            "telephone_number": "650-240-8000",
            "fax_number": "650-240-0953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLS-PENINSULA MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "SHARON",
        "authorized_official_title_or_position": "VP OF MEDICAL MANAGEMENT PRIVACY OF",
        "authorized_official_telephone_number": "650-240-8053",
        "authorized_official_credential": "RN,ND"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, 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.