Mills-Peninsula Health Services

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

License

052340 Issued in CA

Legal business name

MILLS-PENINSULA HEALTH SERVICES

Doing business as

Mills Dialysis Center

Practice address

100 S San Mateo Dr
San Mateo, CA 94401-3805

Phone

(650) 696-5400

Fax

(650) 652-3052

NPI assigned

Jun 15, 2006

Last updated

Feb 27, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brian Trent Hunter

Title

VP Shared Services

Phone

(916) 297-8555

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mills Dialysis Center Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Sutter Bay Medical Foundation

  dba Palo Alto Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Los Gatos, CA
  • NPI 1518696459

  Member Of

  NPD member

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393459200000",
    "number": "1851335335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742738",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742738",
            "telephone_number": "650-696-5400",
            "fax_number": "650-652-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S SAN MATEO DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013805",
            "telephone_number": "650-696-5400",
            "fax_number": "650-652-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLS-PENINSULA HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2014-02-27",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "TRENT",
        "authorized_official_title_or_position": "VP SHARED SERVICES",
        "authorized_official_telephone_number": "916-297-8555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": "CA",
            "license": "052340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CDC03516F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mills Dialysis Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Judy Miller
• Tequilla S Miller
• Mills Peninsula Emergency Medical Associates Inc
• Mills Peninsula Medical Group
• Mills-Peninsula Health Services (Mills Hospital)
• Mills-Peninsula Health Services (Mills Peninsula Extended Care)
• Carl Lyon Millward
• Ronna Milo Haglili, PSYD
• Bryan Robert Milonja, M.A.
• Lauren Milton

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in San Mateo, CA
• Providers in San Mateo, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; 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.