Organization Active NPI

Glenn G. Soppe MD PC

  • Family Medicine Physician
  • Encinitas, CA
National Provider Identifier
1114910841
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GLENN G. SOPPE MD PC
Practice address
345 Saxony Rd
Suite 204
Encinitas, CA 92024-2787
Phone
(760) 944-8402
NPI assigned
Aug 29, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Glenn Soppe, MD
Title
Owner
Phone
(760) 944-8484

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X CA Primary

Addresses

Primary practice location

345 Saxony Rd
Suite 204
Encinitas, CA 92024-2787

Mailing address

345 Saxony Rd
Suite 204
Encinitas, CA 92024-2787
Phone (760) 944-8402

National Provider Directory

National Provider Directory

Locations

345 Saxony Rd
Ste 204
Encinitas, CA 92024
Phone (760) 753-7127

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114910841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SAXONY RD",
            "address_2": "SUITE 204",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242787",
            "telephone_number": "760-944-8402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAXONY RD",
            "address_2": "SUITE 204",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242787",
            "telephone_number": "760-944-8402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN G. SOPPE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SOPPE",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-944-8484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.