Active NPI
Stephen Gary Mlawsky, M.D.
- Surgery Physician
- Larkspur, CA
National Provider Identifier
1558044289
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- G56467
- Practice address
- 228 Old Quarry Rd N
Larkspur, CA 94939 - Phone
- (916) 849-6178
- NPI assigned
- Aug 9, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G56467 | CA | |
| General Practice Physician | 208D00000X | G56467 | CA | |
| Surgery Physician | 208600000X | G56467 | CA | Primary |
Addresses
Primary practice location
228 Old Quarry Rd N
Larkspur, CA 94939
Mailing address
PO Box 2537
Mill Valley, CA 94942
Phone (916) 849-6178
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 |
|---|---|---|---|
| G56467 | CA | MD | General Practice Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691539200000",
"number": "1558044289",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2537",
"city": "MILL VALLEY",
"state": "CA",
"postal_code": "94942",
"telephone_number": "916-849-6178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "228 OLD QUARRY RD N",
"city": "LARKSPUR",
"state": "CA",
"postal_code": "94939",
"telephone_number": "916-849-6178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MLAWSKY",
"first_name": "STEPHEN",
"middle_name": "GARY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-08-09",
"last_updated": "2023-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "G56467",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "G56467",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "G56467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Larkspur, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.