Active NPI
Robert J Pelzar, DMD
- Dentist
- San Carlos, CA
National Provider Identifier
1164597332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 41664
- Practice address
- 501 Walnut St
San Carlos, CA 94070-2321 - Phone
- (650) 592-3436
- Fax
- (650) 654-1847
- NPI assigned
- Nov 22, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 41664 | CA | Primary |
Addresses
Primary practice location
501 Walnut St
San Carlos, CA 94070-2321
Mailing address
501 Walnut St
San Carlos, CA 94070-2321
Phone (650) 592-3436
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41664 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1431907200000",
"number": "1164597332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "501 WALNUT ST",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940702321",
"telephone_number": "650-592-3436",
"fax_number": "650-654-1847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 WALNUT ST",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940702321",
"telephone_number": "650-592-3436",
"fax_number": "650-654-1847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELZAR",
"first_name": "ROBERT",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-22",
"last_updated": "2015-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "41664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.