Individual provider Active NPI

George Richard Oldham, M.D

  • Emergency Medicine Physician
  • Redwood City, CA
National Provider Identifier
1336189182
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
G79685 Issued in CA
Practice address
170 Alameda de Las Pulgas
Redwood City, CA 94062
Phone
(650) 367-5541
NPI assigned
Jun 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X G79685 CA Primary

Addresses

Primary practice location

170 Alameda de Las Pulgas
Redwood City, CA 94062

Mailing address

2100 Powell Street
Ste 920
Emeryville, CA 94608-1803
Phone (510) 350-2600

Other identifiers 1

IdentifierTypeStateIssuer
00G796850MedicaidCA

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G79685CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California Emergency Medicine CurrentSince Jul 1, 1996 Accepting new patients
Cep America - California Emergency Medicine CurrentSince Jul 1, 1996 Accepting new patients
Cep America - California Emergency Medicine Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

170 Alameda de las Pulgas
Redwood City, CA 94062
Phone (650) 367-5536

4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156

Organizations & group practices 3

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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216339200000",
    "number": "1336189182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL STREET",
            "address_2": "STE 920",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081803",
            "telephone_number": "510-350-2600",
            "fax_number": "510-879-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 ALAMEDA DE LAS PULGAS",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "94062",
            "telephone_number": "650-367-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDHAM",
        "first_name": "GEORGE",
        "middle_name": "RICHARD",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "G79685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G796850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

Verify at the official NPI Registry.