# MID PENINSULA EYE PHYSICIANS & SURGEONS MEDICAL GROUP

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** PACIFIC EYE SPECIALISTS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407924889
- **Authorized official:** NATALIE KASUMOV (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (650) 342-4595

## Contact information

- **Practice address:** 50 S SAN MATEO DR, SUITE 200, SAN MATEO, CA 94401-3857
- **Practice address phone:** (650) 342-4595
- **Practice address fax:** (650) 342-3932
- **Mailing address:** 50 S SAN MATEO DR, SUITE 200, SAN MATEO, CA 94401-3857
- **Mailing address phone:** (650) 342-4595
- **Mailing address fax:** (650) 342-3932

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | TAX ID\# | CA | Yes |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 07/21/2022