Active NPI
Charles Holland
- Driver
- San Mateo, CA
National Provider Identifier
1477265890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- R0611362
- Practice address
- 2000 Alameda de Las Pulgas
San Mateo, CA 94403-1269 - Phone
- (650) 573-3689
- NPI assigned
- Dec 16, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Driver | 172A00000X | R0611362 | CA | Primary |
Addresses
Primary practice location
2000 Alameda de Las Pulgas
San Mateo, CA 94403-1269
Mailing address
1854 Bay Rd
East Palo Alto, CA 94303-1311
Phone (650) 921-8717
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R0611362 | CA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1671148800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671148800000",
"number": "1477265890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1854 BAY RD",
"city": "EAST PALO ALTO",
"state": "CA",
"postal_code": "943031311",
"telephone_number": "650-921-8717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 ALAMEDA DE LAS PULGAS",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944031269",
"telephone_number": "650-573-3689"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLAND",
"first_name": "CHARLES",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-12-16",
"last_updated": "2022-12-16",
"certification_date": "2022-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "CA",
"license": "R0611362",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.