Adrienne McGrael Souders MD Inc

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

G048839 Issued in CA

Legal business name

ADRIENNE MCGRAEL SOUDERS MD INC

Practice address

1 Baywood Ave
Ste 5
San Mateo, CA 94402-1537

Phone

(650) 375-7706

Fax

(650) 375-7899

NPI assigned

Jul 11, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Adrienne L McGrael Souders, MD

Title

Owner

Phone

(650) 375-7706

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1093979767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAYWOOD AVE",
            "address_2": "STE 5",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021537",
            "telephone_number": "650-375-7706",
            "fax_number": "650-375-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAYWOOD AVE",
            "address_2": "STE 5",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944021537",
            "telephone_number": "650-375-7706",
            "fax_number": "650-375-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADRIENNE MCGRAEL SOUDERS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "MCGRAEL SOUDERS",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-375-7706",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "G048839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Adelson, NP
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• All providers in San Mateo, CA
• Addiction Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.