Active NPI
Michael Wayne Triantos, M.D.
- Pediatrics Physician
- Los Gatos, CA
National Provider Identifier
1619133972
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G 30669
- Practice address
- 15000 Los Gatos Blvd
Suite #4
Los Gatos, CA 95032-2017 - Phone
- (408) 358-2624
- Fax
- (408) 358-3375
- NPI assigned
- Aug 5, 2008
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G 30669 | CA | Primary |
Addresses
Primary practice location
15000 Los Gatos Blvd
Suite #4
Los Gatos, CA 95032-2017
Mailing address
15000 Los Gatos Blvd
Suite #4
Los Gatos, CA 95032-2017
Phone (408) 358-2624
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 |
|---|---|---|---|
| G 30669 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217894400000",
"number": "1619133972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15000 LOS GATOS BLVD",
"address_2": "SUITE #4",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950322017",
"telephone_number": "408-358-2624",
"fax_number": "408-358-3375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15000 LOS GATOS BLVD",
"address_2": "SUITE #4",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950322017",
"telephone_number": "408-358-2624",
"fax_number": "408-358-3375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRIANTOS",
"first_name": "MICHAEL",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-08-05",
"last_updated": "2008-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G 30669",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Gatos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.