| CS Pacs 3 Ca Medical Group Inc | |
|
1949 Grant Rd Mountain View CA 94040-3217 | |
| (650) 968-2990 | |
| Not Available |
| Full Name | CS Pacs 3 Ca Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1949 Grant Rd, Mountain View, California |
| Authorized Official Name and Position | Bruce Gipe (OWNER/PRESIDENT) |
| Authorized Official Contact | 8656931000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| CS Pacs 3 Ca Medical Group Inc 1643 Nw 136th Avenue Bldg H, Suite 100 Sunrise FL 33323-2857 Ph: (865) 500-1325 | CS Pacs 3 Ca Medical Group Inc 1949 Grant Rd Mountain View CA 94040-3217 Ph: (650) 968-2990 |
| NPI Number | 1922775360 |
|---|---|
| Provider Enumeration Date | 08/24/2021 |
| Last Update Date | 03/06/2025 |
| Certification Date | 03/06/2025 |
| Medicare PECOS PAC ID | 1153843180 |
|---|---|
| Medicare Enrollment ID | O20250319003700 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922775360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 208M00000X | Hospitalist | () | Secondary |
| 363A00000X | Physician Assistant | () | Secondary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| Provider Name | Mary E Gimness |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205934593 PECOS PAC ID: 9133160468 Enrollment ID: I20050517001015 |
| Provider Name | Omar Coltrane Staples |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700931631 PECOS PAC ID: 8123045051 Enrollment ID: I20051028001052 |
| Provider Name | Robert Silva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225129836 PECOS PAC ID: 2062574387 Enrollment ID: I20081222000179 |
| Provider Name | Bruce Silver |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1679545743 PECOS PAC ID: 2062414048 Enrollment ID: I20140422001469 |
| Provider Name | Mary Louis Manavalan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043529803 PECOS PAC ID: 2365661212 Enrollment ID: I20140909000244 |
| Provider Name | Brett J Halloran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235280470 PECOS PAC ID: 0244304715 Enrollment ID: I20140930002357 |
| Provider Name | Lourdes Cruz Garin Isarraras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811410145 PECOS PAC ID: 8224301858 Enrollment ID: I20170901002756 |
| Provider Name | Sara Q Bughio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578818787 PECOS PAC ID: 4981983095 Enrollment ID: I20180212000882 |
| Provider Name | Mandakini Hersh Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457739161 PECOS PAC ID: 9436466752 Enrollment ID: I20191028000801 |
| Provider Name | Gloriely Ducusin Dumaguing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821679416 PECOS PAC ID: 0446641187 Enrollment ID: I20220106001911 |
| Provider Name | Grethel Joy Roa Escala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528743697 PECOS PAC ID: 5496282311 Enrollment ID: I20241217001325 |
| Provider Name | Tyson John Mcmullen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154006757 PECOS PAC ID: 3678071230 Enrollment ID: I20250812003830 |
Alfred Butner, M.D. Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2204 Grant Rd, Suite 203, Mountain View, CA 94040 Phone: 650-960-1100 Fax: 650-964-0991 |
Bileg MD Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2500 Hospital Dr Ste 4b, Mountain View, CA 94040 Phone: 650-669-8581 Fax: 650-658-8648 |
Joyce Tatelman MD, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2204 Grant Rd, Suite 104, Mountain View, CA 94040 Phone: 650-528-5110 Fax: 650-528-5115 |
Samuel N Marcus MD Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2490 Hospital Dr, Suite 211, Mountain View, CA 94040 Phone: 650-988-7488 Fax: 650-988-7486 |
Google Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1310 Shorebird Way, Mountain View, CA 94043 Phone: 650-386-0088 Fax: 650-651-1562 |
George Triadafilopoulos MD Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2490 Hospital Dr, Ste. 211, Mountain View, CA 94040 Phone: 650-988-7488 Fax: 650-396-5566 |