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PENINSULA OBGYN INTEGRATIVE
NPI 1669957114
Obstetrics & Gynecology in San Mateo, CA

Active since October 01, 2018CLIA 05D2172281 · Microscopy
101 S SAN MATEO DR STE 111, SAN MATEO, CA 94401(650) 542-0092(650) 389-6960 Get Directions Write a Review

NPPES record last updated: August 19, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 19, 2019, Apr 3, 2019, Oct 1, 2018 (3 updates tracked since 2018).

About Peninsula Obgyn Integrative NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENINSULA OBGYN INTEGRATIVE (NPI 1669957114) is a healthcare organization registered as an obstetrics & gynecology in San Mateo, California and active in the NPI registry since October 2018. The organization holds a CLIA Microscopy certificate valid through September 17, 2027 and lists Samuel Young, President, as its authorized official.

NPPES Registry Identity

NPI1669957114
Entity TypeOrganization
Primary Taxonomy207V00000X
Legal Business NamePENINSULA OBGYN INTEGRATIVE
Location Address101 S SAN MATEO DR STE 111San Mateo, CA 94401-3840
Mailing Address205 De Anza Blvd # 72San Mateo, CA 94402-3989 · (650) 281-8716
Phone(650) 542-0092
Fax(650) 389-6960
Organization SubpartNo
Authorized OfficialSamuel YoungPresident · (650) 281-8716
Enumeration DateOctober 1, 2018
Last NPPES UpdateAugust 19, 20193 updates tracked since enumeration
✔ NPI 1669957114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
101 S SAN MATEO DR STE 111, San Mateo, CA 94401
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D2172281

Peninsula Obgyn Integrative · San Mateo, CA
Active · expires Sep 17, 2027
CLIA Number05D2172281
Laboratory TypePhysician Office
Certificate Effective DateSeptember 18, 2025
Certificate Expiration DateSeptember 17, 2027
Laboratory DirectorSamuel Young
Laboratory Phone(650) 542-0092
Laboratory LocationPeninsula Obgyn Integrative101 South San Mateo Drive Suite 111, San Mateo, CA 94401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peninsula Obgyn Integrative's NPI number?

The NPI number for Peninsula Obgyn Integrative is 1669957114. It was assigned to this organization in the NPPES registry on October 1, 2018.

Where is Peninsula Obgyn Integrative located?

Peninsula Obgyn Integrative is located at 101 S San Mateo Dr Ste 111, San Mateo, CA 94401. The listed phone number is (650) 542-0092.

What is Peninsula Obgyn Integrative's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Does Peninsula Obgyn Integrative hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D2172281) is associated with this NPI, valid through September 17, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Peninsula Obgyn Integrative was last updated on August 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.