Mills-Peninsula Health Services

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

555482 Issued in CA

Legal business name

MILLS-PENINSULA HEALTH SERVICES

Doing business as

Mills Peninsula Extended Care

Practice address

101 So San Mateo Dr
San Mateo, CA 94401-3805

Phone

(650) 696-5400

Fax

(696) 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 Peninsula Extended Care 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

Locations

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": "1891739298",
    "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": "696-652-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SO SAN MATEO DR",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013805",
            "telephone_number": "650-696-5400",
            "fax_number": "696-652-3052"
        }
    ],
    "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "555482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LTC55482F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mills Peninsula Extended Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• Skilled Nursing Facility in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Skilled Nursing Facility 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.