Individual provider Active NPI

Randall A Ammon, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Orinda, CA
National Provider Identifier
1306933783
Registry record updated May 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
C38335 Issued in CA
Practice address
1 Country Club PLZ
Orinda, CA 94563-2308
Phone
(925) 254-3805
Fax
(925) 254-9783
NPI assigned
Oct 6, 2006
Last updated
May 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X C38335 CA Primary

Addresses

Primary practice location

1 Country Club PLZ
Orinda, CA 94563-2308

Mailing address

1 Country Club PLZ
Orinda, CA 94563-2308
Phone (925) 254-3805

Other identifiers 2

IdentifierTypeStateIssuer
00C383350OtherCALICENSE
94-1741627OtherCATAX ID#

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
C38335CAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Infectious Disease CurrentSince Oct 1, 2002 Accepting new patients

Locations

1 Country Club Plz
Orinda, CA 94563
Phone (925) 254-3805

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212019200000",
    "number": "1306933783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 COUNTRY CLUB PLZ",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632308",
            "telephone_number": "925-254-3805",
            "fax_number": "925-254-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COUNTRY CLUB PLZ",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632308",
            "telephone_number": "925-254-3805",
            "fax_number": "925-254-9783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMMON",
        "first_name": "RANDALL",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2008-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "C38335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "00C383350",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "94-1741627",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orinda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.