Active NPI
Mark A. Alderdice, M.D.
- Emergency Medicine Physician
- Daly City, CA
National Provider Identifier
1689612871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- G62209
- Practice address
- 1900 Sullivan Ave
Daly City, CA 94015-2200 - Phone
- (415) 992-4000
- NPI assigned
- Jun 2, 2006
- Last updated
- Jul 21, 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | G62209 | CA | Primary |
Addresses
Primary practice location
1900 Sullivan Ave
Daly City, CA 94015-2200
Mailing address
2100 Powell St
Suite 900
Emeryville, CA 94608-1826
Phone (510) 350-2600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G622090 | 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 |
|---|---|---|---|
| 62209 | CA | MD | Pharmacist |
| G62209 | CA | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216598400000",
"number": "1689612871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL ST",
"address_2": "SUITE 900",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081826",
"telephone_number": "510-350-2600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 SULLIVAN AVE",
"city": "DALY CITY",
"state": "CA",
"postal_code": "940152200",
"telephone_number": "415-992-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALDERDICE",
"first_name": "MARK",
"middle_name": "A.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-02",
"last_updated": "2008-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "CA",
"license": "G62209",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G622090",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Daly City, CA
- Ahmc Seton Medical Center LLC (Seton Medical Center,Seton Medical Center Coastside)
- Marjorie Mee Ahn, DDS
- Nesrin Akin
- Andrew Alarid
- Fanny Albano, OTR/L
- Aldrich Sy, DDS, MD Inc
- Alfredo a Dela Rosa DDS Inc (A.R. Oral Surgery and Implant Center)
- Zakariya Abdi Ali
- Edgardo Alicaway, MD
- Alice Yan, MD, Incorporated
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.