2025-11-12T10:04:35-06:00 2024-12-31 873710909 HICKOK WATERMAN 2110 S BASCOM AVE STE 103 CAMPBELL CA 950083299 990 2024-01-01 331223596 MEDICAL STAFF OF CALIFORNIA PACIFIC MEDICAL CENTER MEDI 5713340462 3701 SACRAMENTO STREET 172 SAN FRANCISCO CA 94118 IAN JAFFEE MD TREASURER 5713340462 2025-11-12 1 0 ERIC S HICKOK P02469672 4082658400 2025-11-12 X 2024 2025-03-06 01:10:19Z TOM PEITZ MD 3701 SACRAMENTO STREET 172 SAN FRANCISCO CA 94118 1261697 0 X N/A X 2012 CA OVERSIGHT OF THE QUALITY OF CARE PROVIDED BY MEMBERS, ACCOMPLISHED THROUGH CREDENTIALING OF APPLICANTS AND MEMBERS, PEER REVIEW OF CARE, AND REPRESENTING THE INTERESTS OF MEMBERS IN RELATIONS WITH HOSPITAL ADMINISTRATION AND BOARD. 18 18 0 0 0 0 666063 843080 0 0 12034 38384 -27495 0 650602 881464 0 0 0 0 458880 474905 0 0 0 256040 322043 714920 796948 -64318 84516 1593806 1850831 69619 99030 1524187 1751801 OVERSIGHT OF THE QUALITY OF CARE PROVIDED BY MEMBERS, ACCOMPLISHED THROUGH CREDENTIALING OF APPLICANTS AND MEMBERS, PEER REVIEW OF CARE, AND REPRESENTING THE INTERESTS OF MEMBERS IN RELATIONS WITH HOSPITAL ADMINISTRATION AND BOARD. 0 0 PROMOTE AND MAINTAIN HIGH QUALITY PATIENT CARE THAT IS COMMENSURATE WITH AVAILABLE RESOURCES FOR ALL PATIENTS TREATED IN ANY FACILITIES OR SERVICES OF THE HOSPITAL, WHILE SERVING AS THE PATIENT ADVOCATE AT ALL LEVELS OF CARE. MAINTAIN AND IMPROVE THE QUALITY OF CARE RENDERED AND PROVIDE OVERSIGHT OF CARE, TREATMENT, AND SERVICES PROVIDED BY ALL PRACTITIONERS AUTHORIZED TO PRACTICE IN THE HOSPITAL THROUGH AN APPROPRIATE DELINEATION OF CLINICAL PRIVELEGES AND THROUGH UNIFORM AND ONGOING REVIEW AND EVALUATION OF EACH PRACTITIONER'S PERFORMANCE IN THE HOSPITAL. PROVIDE AN EDUCATIONAL SETTING TO MAINTAIN SCIENTIFIC STANDARDS, FURTHER MEDICAL EDUCATION AND CLINICAL INVESTIGATION, AND LEAD TO CONTINUOUS ADVANCEMENT IN PROFESSIONAL KNOWLEDGE AND SKILL. 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 1 1 0 1 1 0 0 1 0 1 1 0 1 0 CA X HEATHER SMITH 4082658400 2110 S BASCOM AVE STE 103 CAMPBELL CA 95008 TOM PEITZ MD CHIEF OF STAFF 15.00 X X 125000 0 0 CLAUDIA MUELLER MD VICE CHIEF OF STAFF 1.20 X X 8333 0 0 MARIE LA PENTA MCHENRY MD VICE CHIEF OF STAFF 5.80 X X 41667 0 0 IAN JAFFE MD TREASURER 5.00 X X 25000 0 0 STEFANI WEDL MD SECRETARY 5.00 X X 25000 0 0 JENNIFER GUY MD DIRECTOR 2.00 X 24000 0 0 BRIAN MICHAEL PARRETT MD DIRECTOR 2.00 X 23400 0 0 YILE DING MD CME COMMITTEE CHAIR 5.00 X 14400 0 0 VINAYAK JHA MD DIRECTOR 2.00 X 5700 0 0 LEWIS Z LENG MD DIRECTOR 2.00 X 23400 0 0 HIDEKI PAUL CHIN MD DIRECTOR 2.00 X 23400 0 0 MEGAN E FAUGHNAN MD DIRECTOR 2.00 X 6000 0 0 JENNIFER GUY MD PHYSICAL WELLNESS COMMITTE 5.00 X 5826 0 0 CLAUDIA MUELLER MD DIRECTOR 2.00 X 2100 0 0 FABIOLA COBARRUBIAS MD DIRECTOR 2.00 X 3300 0 0 MIMI LIN MD DIRECTOR 2.00 X 6300 0 0 RITIK CHANDRA MD DIRECTOR 2.00 X 6600 0 0 ABIGAIL PEASE MD DIRECTOR 2.00 X 23400 0 0 ADITI MANDPE MD DIRECTOR 2.00 X 19080 0 0 IAN JAFFE MD DIRECTOR 2.00 X 23400 0 0 IRA SHARLIP MD DIRECTOR 2.00 X 16200 0 0 SACHA NIEMI MD DIRECTOR 2.00 X 23400 0 0 474906 0 0 1 0 0 0 0 505700 337380 843080 38074 38074 380543 380233 310 310 310 881464 0 0 38384 474905 14680 3153 19177 MEDICAL STAFF SERVICES: 98910 MEDICAL STAFF EVENT: GO 69999 MEDICAL STAFF EVENT: HO 54078 PAY SIMPLE AND MERCHANT 13786 48260 796948 163751 249450 10274 191865 1419781 1409516 1593806 1850831 69619 99030 69619 99030 X 1524187 1751801 1524187 1751801 1593806 1850831 84516 143098 0 X 0 0 0 0 0 0 1 0 FORM 990, PART VI, SECTION A, LINE 6 MEMBERS CONSIST OF ALL LICENSED PHYSICIANS HOLDING EITHER M.D. OR D.O. DEGREES, DENTISTS, AND PODIATRISTS WHO ARE PRIVILEGED TO ADMIT, TREAT, OR CONSULT ON PATIENTS IN CALIFORNIA PACIFIC MEDICAL CENTER HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A ALL ACTIVE STAFF MEMBERS HAVE THE PREROGATIVE TO VOTE ON MATTERS PRESENTED AT GENERAL AND SPECIAL MEETINGS OF THE MEDICAL STAFF, INCLUDING ELECTION OF OFFICERS AND MEMBERS AT LARGE. PODIATRISTS AND DENTISTS SHALL NOT VOTE ON ANY OF THOSE MATTERS BEYOND THE SCOPE OF THEIR LICENSURE. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE TREASURER OF THE ORGANIZATION FOR REVIEW AND SIGNATURE, PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 15B OFFICER STIPENDS ARE DETERMINED BY THE BOARD COMPENSATION COMMITTEE IN ITS ANNUAL MEETING. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST.