Individual provider Active NPI

Alfred Thomas Pepino, M.D.

  • General Practice Physician
  • Dana Point, CA
National Provider Identifier
1073841904
Registry record updated Dec 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G-12460 Issued in CA
Practice address
33946 Cape Cove
Dana Point, CA 92629
Phone
(949) 388-4191
NPI assigned
Dec 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G-12460 CA Primary

Addresses

Primary practice location

33946 Cape Cove
Dana Point, CA 92629

Mailing address

P.O. Box 2641
Mission Viejo, CA 92690-0641
Phone (949) 388-4191

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G-12460CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259884800000",
    "number": "1073841904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2641",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926900641",
            "telephone_number": "949-388-4191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33946 CAPE COVE",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "92629",
            "telephone_number": "949-388-4191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEPINO",
        "first_name": "ALFRED",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-12-04",
        "last_updated": "2009-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G-12460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dana Point, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.