NPIMap

Individual provider Active NPI

San Tso, D.O.

  • Family Medicine Physician
  • Stockton, CA
National Provider Identifier
1598876716
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A7328 Issued in CA
Practice address
77 W March LN
Suite a
Stockton, CA 95207-5723
Phone
(209) 477-5552
Fax
(209) 477-5553
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A7328 CA Primary

Addresses

Primary practice location

77 W March LN
Suite a
Stockton, CA 95207-5723

Mailing address

77 W March LN
Suite a
Stockton, CA 95207-5723
Phone (209) 477-5552

Other identifiers 1

IdentifierTypeStateIssuer
00AX73280MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041230000734 CA Practitioner - Family Practice 7618935065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HT Family Physicians IncGroup PAC ID 1254494479, 4 clinicians

Practice addresses (Care Compare)

999 S Fairmont Ave
Suite 215
Lodi, CA 95240-5142
Phone (209) 477-5552

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7328CAMDFamily Medicine Physician
7328CAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
HT Family Physicians, Inc. Family Medicine CurrentSince Dec 19, 2005 Accepting new patients
Port City Operating Company, LLC Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Dameron Hospital Association Past Accepting new patients

Locations

999 S Fairmont Ave
Ste 215
Lodi, CA 95240
Phone (209) 333-8510

1801 E March Ln
Ste A170
Stockton, CA 95210
Phone (209) 477-5552

77 W March Ln
Ste A
Stockton, CA 95207
Phone (209) 477-5552

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: stso24815@hpmg.direct-ci.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1598876716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W MARCH LN",
            "address_2": "SUITE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075723",
            "telephone_number": "209-477-5552",
            "fax_number": "209-477-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W MARCH LN",
            "address_2": "SUITE A",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075723",
            "telephone_number": "209-477-5552",
            "fax_number": "209-477-5553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSO",
        "first_name": "SAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A7328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX73280",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.