MEDICARE: SUMMER HEALTH MEDICAL GROUP OF CALIFORNIA PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1275351736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMER HEALTH MEDICAL GROUP OF CALIFORNIA PC

Provider Business Mailing Address
First Line	:	169 MADISON AVE STE 11579
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-5101
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	177 POST ST STE 920
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94108-4712
Country	:	US
Telephone Number	:	908-312-3755
Fax Number	:

Authorized Official
Title or Position	:	HEAD OF MEDICAL GROUP
Name	:	DR. LEO DAMASCO
Credential	:
Telephone Number	:	240-338-0567

Provider Enumeration Date	:	10/02/2024
Last Update Date	:	04/22/2025

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