Individual provider Active NPI

Robert K Koida, M.D.

  • Family Medicine Physician
  • Sonoma, CA
National Provider Identifier
1275646507
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G20444 Issued in CA
Practice address
181 Andrieux St
Suite 201
Sonoma, CA 95476-6932
Phone
(707) 938-3870
Fax
(707) 938-3895
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G20444 CA Primary

Addresses

Primary practice location

181 Andrieux St
Suite 201
Sonoma, CA 95476-6932

Mailing address

181 Andrieux St
Suite 201
Sonoma, CA 95476-6932
Phone (707) 938-3870

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

LicenseStateTypeSpecialty
G20444CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prima Medical Foundation Past Accepting new patients
Prima Medical Group, Inc. Family Medicine PastSince May 1, 2010 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275646507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 ANDRIEUX ST",
            "address_2": "SUITE 201",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766932",
            "telephone_number": "707-938-3870",
            "fax_number": "707-938-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 ANDRIEUX ST",
            "address_2": "SUITE 201",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766932",
            "telephone_number": "707-938-3870",
            "fax_number": "707-938-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIDA",
        "first_name": "ROBERT",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G20444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonoma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.