Healthcare Provider Details

I. General information

NPI: 1275351736
Provider Name (Legal Business Name): SUMMER HEALTH MEDICAL GROUP OF CALIFORNIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2024
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 POST ST STE 920
SAN FRANCISCO CA
94108-4712
US

IV. Provider business mailing address

169 MADISON AVE STE 11579
NEW YORK NY
10016-5101
US

V. Phone/Fax

Practice location:
  • Phone: 908-312-3755
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LEO DAMASCO
Title or Position: HEAD OF MEDICAL GROUP
Credential:
Phone: 240-338-0567