Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
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
975 SERENO DRIVE, VALLEJO, CA 94589-2441
(707) 651-1000
Mailing address
5820 OWENS DR. BUILDING E, 2ND FLOOR, TPMG FINANCIAL MANAGEMENT, PLEASANTON, CA 94588-3900
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
—
—
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
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0015722
—
CA
05
—
GR0046770
—
CA
05
—
GRN000111
—
CA
05
—
LAB85875F
—
CA
05
—
ZZZ20727Z
—
CA
05
—
ZZZ20735Z
—
CA
05
—
ZZZ20736Z
—
CA
01
—
ZZZ31052Z
BLUE SHIELD
—
Enumeration date
10/23/2006
Last updated
04/14/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up