Active NPI
David P Enfield, MD
- Anatomic Pathology Physician
- Stockton, CA
National Provider Identifier
1518991942
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- G791360
- Practice address
- 1800 N California St
Stockton, CA 95204-6019 - Phone
- (209) 473-6555
- Fax
- (209) 473-6544
- NPI assigned
- Jul 10, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | G791360 | CA | Primary |
Addresses
Primary practice location
1800 N California St
Stockton, CA 95204-6019
Mailing address
3116 W March LN Ste 200
Stockton, CA 95219-2370
Phone (209) 473-6555
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G79136 | Other | CA | STATE LICENSE # |
| 00G791360 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 79136 | CA | MD | Pharmacist |
| G791360 | CA | MD | Anatomic Pathology Physician |
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.
-
- Anatomic Pathology Physician
- Pleasanton, CA
- NPI 1477582161
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518991942",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3116 W MARCH LN STE 200",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952192370",
"telephone_number": "209-473-6555",
"fax_number": "209-473-6544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 N CALIFORNIA ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952046019",
"telephone_number": "209-473-6555",
"fax_number": "209-473-6544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENFIELD",
"first_name": "DAVID",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "CA",
"license": "G791360",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE #",
"identifier": "G79136",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G791360",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Stockton, 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.