Peninsula Dialysis Access, LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PENINSULA DIALYSIS ACCESS, LLC

Practice address

91 Westborough Blvd
Ste. 2010
South San Francisco, CA 94080-3162

Phone

(650) 871-2449

NPI assigned

Mar 5, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Cynthia M Jansen

Title

Ceo

Phone

(714) 404-6855

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1267747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267747200000",
    "number": "1780907600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 S WOODLAND ST",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928695229",
            "telephone_number": "714-404-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 WESTBOROUGH BLVD",
            "address_2": "STE. 2010",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803162",
            "telephone_number": "650-871-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA DIALYSIS ACCESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-05",
        "last_updated": "2010-03-05",
        "status": "A",
        "authorized_official_last_name": "JANSEN",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-404-6855",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin Paz, MD
• Keon Pearson, MD
• Danilo Pedroso
• Yessenia Patricia Pena Ruiz
• Peninsula Dialysis Access Center
• Peninsula Pathologists Medical Group
• Peninsula Sleep Lab
• Rumany Chang Penn, PHARM.D.
• Catherine D. Pepper, LCSW
• Michael Abraham Pepper, MD

• All providers in South San Francisco, CA
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2010; 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.