Organization Active NPI

Stonestown Pediatrics

  • Pediatrics Physician
  • San Francisco, CA
National Provider Identifier
1154486421
Registry record updated Jan 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
FNP30374 Issued in CA
Legal business name
STONESTOWN PEDIATRICS
Practice address
595 Buckingham Way
#355
San Francisco, CA 94132-1909
Phone
(415) 566-2727
Fax
(415) 566-0081
NPI assigned
Dec 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2013

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

Authorized official

Name
Dr. Mitchell C Sollod, M.D.
Title
Secretary
Phone
(415) 566-2727

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X C27394 CA
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X FNP30374 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 1

IdentifierTypeStateIssuer
YYY20778YMedicaidCA

Other names 1

  • Stonestown Pediatric Medical Office Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1154486421",
    "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": {
        "organization_name": "STONESTOWN PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "SOLLOD",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "415-566-2727",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "CA",
            "license": "C27394",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "FNP30374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "YYY20778Y",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stonestown Pediatric Medical Office",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Jan 16, 2013; 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.