Robert Alan Pedrin, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A207830 Issued in CA

Practice address

1125 Sir Francis Drake Blvd
Suite a
Kentfield, CA 94904-1418

Phone

(415) 485-3525

Fax

(415) 454-9093

NPI assigned

Feb 5, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1139097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447222393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 VIA LERIDA",
            "city": "GREENBRAE",
            "state": "CA",
            "postal_code": "949041211",
            "telephone_number": "415-461-3648",
            "fax_number": "415-461-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SIR FRANCIS DRAKE BLVD",
            "address_2": "SUITE A",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041418",
            "telephone_number": "415-485-3525",
            "fax_number": "415-454-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDRIN",
        "first_name": "ROBERT",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A207830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A207830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Kentfield, CA
• Providers in Kentfield, CA by specialty
• Family Medicine Physician in California

• 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.