Charles Sheptin, MD, Inc.

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

G12008 Issued in CA

Legal business name

CHARLES SHEPTIN, MD, INC.

Practice address

1792 Kirkmont Dr
San Jose, CA 95124-1235

Phone

(408) 464-8293

NPI assigned

Sep 17, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles Sheptin, M.D.

Title

Pres

Phone

(408) 464-8293

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275630816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1792 KIRKMONT DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951241235",
            "telephone_number": "408-464-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1792 KIRKMONT DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951241235",
            "telephone_number": "408-464-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES SHEPTIN, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHEPTIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "408-464-8293",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "G12008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G12008",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Medical Specialty Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.