Active NPI
Susan J Dugoni, MD
- Pediatrics Physician
- Fremont, CA
National Provider Identifier
1376603720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G53682
- Practice address
- 2191 Mowry Ave
Suite 600-C
Fremont, CA 94536 - Phone
- (510) 792-4373
- Fax
- (510) 792-3420
- NPI assigned
- Dec 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G53682 | CA | Primary |
Addresses
Primary practice location
2191 Mowry Ave
Suite 600-C
Fremont, CA 94536
Mailing address
2191 Mowry Ave
Suite 600-C
Fremont, CA 94536
Phone (510) 792-4373
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G53682 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376603720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2191 MOWRY AVE",
"address_2": "SUITE 600-C",
"city": "FREMONT",
"state": "CA",
"postal_code": "94536",
"telephone_number": "510-792-4373",
"fax_number": "510-792-3420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2191 MOWRY AVE",
"address_2": "SUITE 600-C",
"city": "FREMONT",
"state": "CA",
"postal_code": "94536",
"telephone_number": "510-792-4373",
"fax_number": "510-792-3420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUGONI",
"first_name": "SUSAN",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G53682",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, 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.