Provider Demographics
NPI:1447046800
Name:BIG LEAP MEDICAL GROUP OF CALIFORNIA P.C.
Entity type:Organization
Organization Name:BIG LEAP MEDICAL GROUP OF CALIFORNIA P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUMEET
Authorized Official - Middle Name:
Authorized Official - Last Name:VADERA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-792-0195
Mailing Address - Street 1:2261 MARKET ST STE 10836
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22281 AMBER ROSE
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-4522
Practice Address - Country:US
Practice Address - Phone:415-792-0195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty