Individual provider Active NPI

Stuart S London, M.D.

  • Diagnostic Radiology Physician
  • Oakland, CA
National Provider Identifier
1083715908
Registry record updated Feb 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
G27002 Issued in CA
Practice address
3330 Telegraph Ave.
Oakland, CA 94609-3028
Phone
(510) 420-8800
Fax
(510) 420-8069
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X G27002 CA Primary

Addresses

Primary practice location

3330 Telegraph Ave.
Oakland, CA 94609-3028

Mailing address

3330 Telegraph Ave.
Oakland, CA 94609-3028
Phone (510) 420-8800

Other identifiers 1

IdentifierTypeStateIssuer
00G270020MedicaidCA

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G27002CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Norcal Imaging Diagnostic Radiology Past Accepting new patients
Emeryville Advanced Imaging Center Diagnostic Radiology PastSince Jan 20, 2010 Accepting new patients
Diagnostic Radiological Imaging Diagnostic Radiology Past Accepting new patients
Vallejo Open MRI Center Diagnostic Radiology Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391558400000",
    "number": "1083715908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 TELEGRAPH AVE.",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093028",
            "telephone_number": "510-420-8800",
            "fax_number": "510-420-8069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 TELEGRAPH AVE.",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093028",
            "telephone_number": "510-420-8800",
            "fax_number": "510-420-8069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONDON",
        "first_name": "STUART",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2014-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "G27002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G270020",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; 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.