Individual provider Active NPI

Mitchell C Sollod, M.D.

  • Pediatrics Physician
  • San Francisco, CA
National Provider Identifier
1083779359
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
C27394 Issued in CA
Practice address
595 Buckingham Way
#355
San Francisco, CA 94132-1909
Phone
(415) 566-2727
Fax
(415) 566-0081
NPI assigned
Dec 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X C27394 CA
Pediatrics Physician 208000000X C27394 CA Primary

Addresses

Primary practice location

595 Buckingham Way
#355
San Francisco, CA 94132-1909

Mailing address

595 Buckingham Way
#355
San Francisco, CA 94132-1909
Phone (415) 566-2727

Other identifiers 2

IdentifierTypeStateIssuer
00C273940MedicaidCA
943234237OtherFEDERAL TAX IDENT NUMBER

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
C27394CAMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184889600000",
    "number": "1083779359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "595 BUCKINGHAM WAY",
            "address_2": "#355",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941321909",
            "telephone_number": "415-566-2727",
            "fax_number": "415-566-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 BUCKINGHAM WAY",
            "address_2": "#355",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941321909",
            "telephone_number": "415-566-2727",
            "fax_number": "415-566-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLLOD",
        "first_name": "MITCHELL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "C27394",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "C27394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C273940",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX IDENT NUMBER",
            "identifier": "943234237",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; 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.