NPIMap

Organization Active NPI

David a South MD & Kim M Albridge MD a Medical Corporation

  • Dermatology Physician
  • Freedom, CA
National Provider Identifier
1194704973
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DAVID A SOUTH MD & KIM M ALBRIDGE MD A MEDICAL CORPORATION
Practice address
204 Green Valley Road
Freedom, CA 95019
Phone
(831) 728-2005
Fax
(831) 728-3310
NPI assigned
Jan 11, 2006
Last updated
Jun 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Authorized official

Name
Dr. David A South, MDNPI 1053470468
Title
President
Phone
(831) 728-2005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

204 Green Valley Road
Freedom, CA 95019

Mailing address

204 Green Valley Road
Freedom, CA 95019
Phone (831) 728-2005

National Provider Directory

National Provider Directory

Locations

204 Green Valley Rd
Freedom, CA 95019
Phone (408) 728-2005

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1194704973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 GREEN VALLEY ROAD",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "95019",
            "telephone_number": "831-728-2005",
            "fax_number": "831-728-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 GREEN VALLEY ROAD",
            "city": "FREEDOM",
            "state": "CA",
            "postal_code": "95019",
            "telephone_number": "831-728-2005",
            "fax_number": "831-728-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A SOUTH MD & KIM M ALBRIDGE MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-11",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "SOUTH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "831-728-2005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freedom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; 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.