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MISSION PEAK ORTHOPAEDIC MEDICAL GROUP INC NPI 1639282551


NPI Information

NPI: 1639282551
Provider Name: MISSION PEAK ORTHOPAEDIC MEDICAL GROUP, INC
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
5924 STONERIDGE DRIVE
SUITE 110
PLEASANTON, CA
ZIP 94588
Phone: (925) 846-6200
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MISSION PEAK ORTHOPAEDIC MEDICAL GROUP, INC is an orthopaedic surgery in Pleasanton, CA. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. MISSION PEAK ORTHOPAEDIC MEDICAL GROUP, INC NPI is 1639282551. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5924 STONERIDGE DRIVE
SUITE 110
PLEASANTON, CA
ZIP 94588-400
Phone: (925) 846-6200
Fax: (510) 797-5184

The provider's authorized official is Lingagoud Memula .
The authorized official title is Administrator and has the following contact phone number (510) 818-2011.

The enumeration date for this NPI number is 8/16/2006 and was last updated on 10/18/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic SurgeryA657720CALIFORNIANo
2208100000XPhysical Medicine & RehabilitationA81391CALIFORNIANo
3208100000XPhysical Medicine & RehabilitationA95318CALIFORNIANo
42081P2900XPhysical Medicine & RehabilitationPain MedicineA81391CALIFORNIANo
5213ES0103XPodiatristFoot & Ankle SurgeryE4711CALIFORNIANo
6363A00000XPhysician AssistantPA17256CALIFORNIANo
7363AS0400XPhysician AssistantSurgicalPA17256CALIFORNIANo
8207X00000XOrthopaedic SurgeryA698780CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZZ5427ZOTHERCALIFORNIABLUE SHIELD
2G09341MEDICARE UPINCALIFORNIA
3ZZZ16527ZMEDICARE PINCALIFORNIA
4I13175MEDICARE UPINCALIFORNIA
5I45989MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.