Individual provider Active NPI

Mark H. Freeman, NP

  • Primary Care Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1710019740
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
NPF3259 Issued in CA
Practice address
50 Lech Walesa
Tom Waddell Clinic
San Francisco, CA 94102-4506
Phone
(415) 355-7490
Fax
(415) 355-7407
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X RN397538 CA
Primary Care Nurse Practitioner 363LP2300X NPF3259 CA Primary

Addresses

Primary practice location

50 Lech Walesa
Tom Waddell Clinic
San Francisco, CA 94102-4506

Mailing address

50 Lech Walesa
Tom Waddell Clinic
San Francisco, CA 94102-4506
Phone (415) 355-7490

Other identifiers 1

IdentifierTypeStateIssuer
056283OtherSFGH INTERNAL USE ONLY-COMMERCIAL NUMBER

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN397538CAMDCommunity Health Registered Nurse
NPF3259CAMDPrimary Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1710019740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LECH WALESA",
            "address_2": "TOM WADDELL CLINIC",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941024506",
            "telephone_number": "415-355-7490",
            "fax_number": "415-355-7407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LECH WALESA",
            "address_2": "TOM WADDELL CLINIC",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941024506",
            "telephone_number": "415-355-7490",
            "fax_number": "415-355-7407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEMAN",
        "first_name": "MARK",
        "middle_name": "H.",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "CA",
            "license": "RN397538",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NPF3259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "056283",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.