Susan Sharon Klaw Trout, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ML60949021 Issued in WA

Practice address

1235 Osos St Ste 100
San Luis Obispo, CA 93401-3619

Phone

(805) 549-0888

Fax

(805) 549-8463

NPI assigned

Mar 20, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles (2 of 3)

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Coast Pediatrics Inc

  • Pediatric Adolescent Medicine Physician
  • Templeton, CA
  • NPI 1083869804
  NPD (past)
• Central Coast Pediatrics Inc

  • Pediatrics Physician
  • San Luis Obispo, CA
  • NPI 1770517724

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719446400000",
    "number": "1255891024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1235 OSOS ST STE 100",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013619",
            "telephone_number": "805-549-0888",
            "fax_number": "805-549-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 OSOS ST STE 100",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013619",
            "telephone_number": "805-549-0888",
            "fax_number": "805-549-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUT",
        "first_name": "SUSAN",
        "middle_name": "SHARON KLAW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-20",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML60949021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Korina Trezza-del Valle
• Charles Lee Tribbey, O.D.
• Shelley Triggs, LMFT
• Brent Alan Trockman, D.C.
• Louisa V. Troemel, PSY.D, L.M.F.T.
• Desiree Melanie Troxell, LMFT
• Maria Margret Trujillo
• Joseph Truppa
• Ke-Ping Tsao, M.D.
• Kenyon Tsao, M.D.

• All providers in San Luis Obispo, CA
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.