Individual provider Active NPI

Robert M Walley, DDS

  • Dentist
  • San Francisco, CA
National Provider Identifier
1013020601
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20958 Issued in CA
Practice address
490 Post St
Suite 1205
San Francisco, CA 94102-1303
Phone
(415) 956-5690
Fax
(415) 421-6260
NPI assigned
Aug 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20958 CA Primary

Addresses

Primary practice location

490 Post St
Suite 1205
San Francisco, CA 94102-1303

Mailing address

490 Post St
Suite 1205
San Francisco, CA 94102-1303
Phone (415) 956-5690

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Mar 3, 2016 through Mar 3, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20958CAMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013020601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 POST ST",
            "address_2": "SUITE 1205",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021303",
            "telephone_number": "415-956-5690",
            "fax_number": "415-421-6260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 POST ST",
            "address_2": "SUITE 1205",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941021303",
            "telephone_number": "415-956-5690",
            "fax_number": "415-421-6260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEY",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "20958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.