John Baskerville Imboden Jr., MD

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

G44969 Issued in CA

Practice address

1001 Potrero Avenue
BLDG 30 RM 3300
San Francisco, CA 94110-3518

Phone

(415) 206-5438

Fax

(415) 648-8425

NPI assigned

Jan 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Division of Vascular Surgery

  • Vascular Surgery Physician
  • San Francisco, CA
  • NPI 1033913959
  NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group Dept of Otolaryngology

  • Otolaryngology Physician
  • San Francisco, CA
  • NPI 1154396208
  NPD
• University of California SFGH Medical Group

  dba UCSF SFGH Medical Group, Toxicology Services

  • Medical Toxicology (Emergency Medicine) Physician
  • San Francisco, CA
  • NPI 1730434333

  Internal Medicine

  NPD

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326758400000",
    "number": "1275689408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7464",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941207464",
            "telephone_number": "415-206-3103",
            "fax_number": "415-206-3872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 POTRERO AVENUE",
            "address_2": "BLDG 30 RM 3300",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941103518",
            "telephone_number": "415-206-5438",
            "fax_number": "415-648-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMBODEN",
        "first_name": "JOHN",
        "middle_name": "BASKERVILLE",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2012-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G44969",
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "G44969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G449690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terry Im I, DDS
• Robert Tsukasa Imagawa, D.D.S.
• Image Guided Therapeutics, Inc.
• Maite Andrea Imaz
• Elizabeth Vinet Imbert, M.D.
• Imenet (Independent Medical Experts Network)
• Richard Imes, MD
• Barbara Ann Imhoff, NP
• Igor Immerman, M.D.
• Immune Enhancement Project

• Rheumatology Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Rheumatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.