Active NPI
DHP of Saint Rose Medical Group Inc
- Obstetrics & Gynecology Physician
- Hayward, CA
National Provider Identifier
1982959128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- Legal business name
- DHP OF SAINT ROSE MEDICAL GROUP INC
- Practice address
- 27200 Calaroga Ave
Hayward, CA 94545-4339 - Phone
- (510) 264-4000
- NPI assigned
- Jul 13, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sujal Mandavia, M.D.
- Title
- President
- Phone
- (865) 693-1000
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | Primary | ||
| Hospitalist Physician | 208M00000X | |||
| Nurse Practitioner | 363L00000X | |||
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X |
Addresses
Primary practice location
27200 Calaroga Ave
Hayward, CA 94545-4339
Mailing address
265 Brookview Centre Way
Suite 400
Knoxville, TN 37919-4052
Phone (865) 693-1000
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342137600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1342742400000",
"number": "1982959128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 BROOKVIEW CENTRE WAY",
"address_2": "SUITE 400",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379194052",
"telephone_number": "865-693-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27200 CALAROGA AVE",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945454339",
"telephone_number": "510-264-4000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DHP OF SAINT ROSE MEDICAL GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-13",
"last_updated": "2012-07-20",
"status": "A",
"authorized_official_last_name": "MANDAVIA",
"authorized_official_first_name": "SUJAL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "865-693-1000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": true
},
{
"code": "208M00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Hospitalist",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LX0001X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.