Individual provider Active NPI

Paul T. Endo, M.D.

  • Internal Medicine Physician
  • Walnut Creek, CA
National Provider Identifier
1568402014
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G35441 Issued in CA
Practice address
1450 Treat Blvd
Suite 250B
Walnut Creek, CA 94597-2168
Phone
(925) 296-9740
Fax
(925) 296-9064
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G35441 CA Primary

Addresses

Primary practice location

1450 Treat Blvd
Suite 250B
Walnut Creek, CA 94597-2168

Mailing address

1450 Treat Blvd # 300
Walnut Creek, CA 94597-2168
Phone (925) 952-2888

Other identifiers 1

IdentifierTypeStateIssuer
00G354410MedicaidCA

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1568402014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD # 300",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-952-2888",
            "fax_number": "925-952-2850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 TREAT BLVD",
            "address_2": "SUITE 250B",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945972168",
            "telephone_number": "925-296-9740",
            "fax_number": "925-296-9064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDO",
        "first_name": "PAUL",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G35441",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G354410",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.