Dr. Elpidio C Mariano
Surgery

Address: 106 Lynch Creek Way, Suite 9b, Petaluma, CA 94954-2356
Phone: 7077631575

Dr. Elpidio C Mariano (NPI# 1063524528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1063524528
Entity Type Individual
Full Name Dr. Elpidio C Mariano
Credential M.D.
Gender Male
Practice Address 106 Lynch Creek Way
Suite 9b
Petaluma
CA 94954-2356
Practice Telephone 7077631575
Practice Fax Number 7077639172
Mailing Address 106 Lynch Creek Way
Suite 9b
Petaluma
CA 94954-2356
Mailing Telephone 7077631575
Mailing Fax Number 7077639172
Sole Proprietor Yes, this individual is a Sole Proprietor
Enumeration Date 2006-08-31
Last Update Date 2010-09-14

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 208600000X Surgery Allopathic & Osteopathic Physicians A39817 CA

Other Provider Identifier

State Identifier Issuer Type Code
CA 00A398170 MEDICAID

Other Providers ELPIDIO MARIANO

NPI Name Taxonomy Address Enumeration
1740260645 Elpidio G Mariano Pathology 1410 N 4 Street, Clinton, IA 52732 2006-01-18
1770593675 Elpidio A Mariano Psychiatry & Neurology 5000 W National Ave, Department of Psychiatry, Milwaukee, WI 53295-0001 2006-08-09

Physician Overview

NPI 1063524528
PAC ID by PECOS 9537356506
Professional Enrollment ID I20101203000589
Full Name Elpidio C Mariano
Organization Legal Name ASP PROVIDERS GROUP OF CALIFORNIA, PC
Phone Number 7077781551
Gender M
Graduation Year 1971
Primary Specialty GENERAL SURGERY
Group Practice PAC ID 0547536245
Number of Group Practice Members 7
Accepts Medicare Assignment Y
Use Electronic Health Records Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
050136 PETALUMA VALLEY HOSPITAL

Office Location

Street Address 106 LYNCH CREEK WAY
SUITE 9B
City PETALUMA
State CA
Zip Code 94954-2356

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710099585 Santiago Alberto Centurion Dermatology 106 Lynch Creek Way, Suite 8, Petaluma, CA 94954-2356 2006-08-31
1295170629 North Bay Dermatology & Skin Cancer Center P C Dermatology 106 Lynch Creek Way, 8, Petaluma, CA 94954-2356 2013-04-29
1700103827 Petaluma Valley Hearing Center Case Management 106 Lynch Creek Way, Suite 9a, Petaluma, CA 94954-2356 2010-04-28
1801006804 Dennis M. Mcleod, M.d., Inc Otolaryngology 106 Lynch Creek Way, Suite 9a, Petaluma, CA 94954-2356 2007-05-22
1710053095 Cristina S Centurion Nurse Practitioner 106 Lynch Creek Way, Suite 8, Petaluma, CA 94954-2356 2006-11-28
1073682142 North Bay Dermatology Assoc Dermatology 106 Lynch Creek Way, #8, Petaluma, CA 94954 2006-11-06
1275622664 North Bay Dermatology Specialist 106 Lynch Creek Way, Suite #8, Petaluma, CA 94954-2356 2006-10-12
1700998259 Cesar P Veluz Surgery 106 Lynch Creek Way, Suite 9b, Petaluma, CA 94954-2356 2006-08-31

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477019917 Rubi Isela Cruz Mendoza I Behavior Analyst 8 Round Walk Circle, Petaluma, CA 94954 2019-02-20
1932679511 Karen Christianson Behavior Technician 1670 Corporate Circle Suite 100, Petaluma, CA 94954 2018-11-27
1669956967 Alyssa Messer Assistant Behavior Analyst 1670 Corporate Cir, Petaluma, CA 94954 2018-09-21
1235620592 Mallory Paige Mullikin Nurse Practitioner 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 2018-05-22
1043730963 Diverse Senior Care Services LLC Home Health 526 Lakeville Cir, Petaluma, CA 94954 2017-06-21
1457723710 Lisabel Dolne Counselor 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 2015-10-27
1083080717 Pacific Restorative Center Clinic/Center 1456 Professional Drive, Suite 404, Petaluma, CA 94954 2015-08-17
1619354198 Accu Quest Hearing Centers Clinic/Center 1456 Professional Dr., Suite 404, Petaluma, CA 94954 2015-05-04
1417364142 Molly Renee Williamson Speech-Language Pathologist 1516 Sarkesian Dr, Petaluma, CA 94954 2014-07-15
1285994244 Tam Tiet Family Medicine 1383 N Mcdowell Blvd Ste 150, Petaluma, CA 94954 2012-05-24
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Taxonomy Information

Taxonomy Code 208600000X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery

Taxonomy Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1316907082 Peter Vincent Leoni Surgery 1116 B St, Petaluma, CA 94952-4054 2006-03-25
1912355397 Russell W. Sawyer, M.d. Professional Corporation Surgery 141 Lynch Creek Way, Suite A, Petaluma, CA 94954-2341 2016-05-26
1245446780 Richard Eugene Altieri Perez Surgery 1456 Professional Dr, Suite #404, Petaluma, CA 94954-6639 2007-05-14
1609912914 Bozuk & Associates Surgical, Inc. Surgery 1456 Professional Dr, Ste. #404, Petaluma, CA 94954-6639 2007-01-30
1700998259 Cesar P Veluz Surgery 106 Lynch Creek Way, Suite 9b, Petaluma, CA 94954-2356 2006-08-31
1700800604 Michael I Bozuk Surgery 3835 Cypress Dr, Ste 202, Petaluma, CA 94954-6965 2006-07-26
1851338537 Keith F. Korver, M.d., Inc. Surgery 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-8003 2006-06-01

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1023575693 Adventist Health Physicians Network Surgery 200 W Roseburg Ave Ste B-100, Modesto, CA 95350-5255 2019-03-01
1700343589 Adventist Health Physicians Network Surgery 5725 W Las Positas Blvd Ste 200, Pleasanton, CA 94588-4007 2019-02-27
1669939468 Md Care Providers Inc Surgery 4295 Jurupa St Ste 117, Ontario, CA 91761-1430 2019-02-27
1386118404 Shirley Domingo, M.d., Inc. Surgery 3939 J St Ste 305, Sacramento, CA 95819-3639 2019-01-11
1154891208 Jay Labourene Surgery 1550 Tiburon Blvd Ste G, Tiburon, CA 94920-2531 2018-12-03
1215407218 Vascular and Endovascular Surgery, PC Surgery 2505 Samaritan Dr Ste 503, San Jose, CA 95124-4015 2018-12-03
1457829319 Cerritos Surgery Center, LLC Surgery 16543 Carmenita Rd, Cerritos, CA 90703-2218 2018-11-08
1902374010 Minimally Invasive Medical Group Surgery 26921 Crown Valley Pkwy Ste 120, Mission Viejo, CA 92691-6501 2018-11-06
1306328265 Wave Medical Group Inc Surgery 720 Paularino Ave Ste 200, Costa Mesa, CA 92626-6917 2018-09-06
1427539287 Mohammad Haghdoost Md Medical Cororation Surgery 1144 Norman Dr Ste 240, Manteca, CA 95336-5925 2018-08-28
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Competitor

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City PETALUMA
Zip Code 94954

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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