Organization Active NPI

Stephen J. Whitgob

  • Family Medicine Physician
  • Berkeley, CA
National Provider Identifier
1235443292
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G024893 Issued in CA
Legal business name
STEPHEN J. WHITGOB
Practice address
2900 Telegraph Ave
Berkeley, CA 94705-2018
Phone
(510) 883-9883
NPI assigned
Aug 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Authorized official

Name
Stephen J. Whitgob
Title
Physician
Phone
(415) 883-9883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X G024893 CA Primary

Addresses

Primary practice location

2900 Telegraph Ave
Berkeley, CA 94705-2018

Mailing address

2900 Telegraph Ave
Berkeley, CA 94705-2018

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1280707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1235443292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052018",
            "telephone_number": "510-883-9883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN J. WHITGOB",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-02",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "WHITGOB",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "415-883-9883"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G024893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.