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Organization
PERMANENTE MEDICAL GROUP INC
Active
Organization
PERMANENTE MEDICAL GROUP INC
Active
Parent organization
PERMANENTE MEDICAL GROUP, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
PERMANENTE MEDICAL GROUP, INC.
Authorized official
MS. PATRICIA T WEST (CHIEF FINANCIAL OFFICER)
(510) 295-7207
Entity
Organization
Contact information
Practice address
710 LAWRENCE EXPRESSWAY, SANTA CLARA, CA 95051-5173
(408) 851-1000
Mailing address
5820 OWENS DR. BUILDING E, 2ND FLOOR, PLEASANTON, CA 94588-3900
(925) 924-6840
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207N00000X
Dermatology Physician
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR001572T
—
CA
05
—
GR001572U
—
CA
05
—
GROO1572P
—
CA
05
—
ZZZ74979Z
—
CA
Enumeration date
10/02/2006
Last updated
11/12/2024
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