Active NPI
Alice Breder, MD
- Pediatrics Physician
- Daly City, CA
National Provider Identifier
1215053897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- A46635
- Practice address
- 901 Campus Dr
Daly City, CA 94015-4900 - Phone
- (650) 652-8720
- Fax
- (650) 994-1126
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A46635 | CA | Primary |
Addresses
Primary practice location
901 Campus Dr
Daly City, CA 94015-4900
Mailing address
325 Distel Cir
Los Altos, CA 94022-1408
Phone (650) 652-8720
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A46635 | Other | CA | STATE LICENSE # |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A46635 | CA | MD | Pediatrics Physician |
Interoperability endpoints
- abreder45870@hisp.ehr.sutterhealth.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583884800000",
"number": "1215053897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 DISTEL CIR",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940221408",
"telephone_number": "650-652-8720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 CAMPUS DR",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940154900",
"telephone_number": "650-652-8720",
"fax_number": "650-994-1126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREDER",
"first_name": "ALICE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2020-03-11",
"certification_date": "2020-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A46635",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE #",
"identifier": "A46635",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Daly City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.