R. Paul St. Amand, M.D., Inc.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

G2487 Issued in CA

Legal business name

R. PAUL ST. AMAND, M.D., INC.

Practice address

4560 Admiralty Way
Ste. 355
Marina del Rey, CA 90292-5423

Phone

(310) 577-7510

Fax

(310) 821-0664

NPI assigned

Aug 3, 2010

Last updated

Aug 3, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Roger P. St. Amand, M.D.

Title

President

Phone

(310) 577-7510

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1280793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280793600000",
    "number": "1780998542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY",
            "address_2": "STE. 355",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925423",
            "telephone_number": "310-577-7510",
            "fax_number": "310-821-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 ADMIRALTY WAY",
            "address_2": "STE. 355",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925423",
            "telephone_number": "310-577-7510",
            "fax_number": "310-821-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R. PAUL ST. AMAND, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-03",
        "last_updated": "2010-08-03",
        "status": "A",
        "authorized_official_last_name": "ST. AMAND",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-577-7510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "CA",
            "license": "G2487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUE SHIELD",
            "identifier": "0006G24870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Endocrinology, Diabetes & Metabolism Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Endocrinology, Diabetes & Metabolism Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2010; 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.