Organization Active NPI

DHP of Saint Rose Medical Group Inc

  • Obstetrics & Gynecology Physician
  • Hayward, CA
National Provider Identifier
1982959128
Registry record updated Jul 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
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

Updated by the provider on Jul 20, 2012

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)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X Primary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Obstetrics & Gynecology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.