Individual provider Active NPI

Thomas T Streeter, M.D.

  • Obstetrics & Gynecology Physician
  • Stockton, CA
National Provider Identifier
1811962145
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A23450 Issued in CA
Practice address
2509 W March LN
Suite 250
Stockton, CA 95207-8252
Phone
(209) 957-1000
Fax
(209) 957-1001
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A23450 CA
Obstetrics & Gynecology Physician 207V00000X A23450 CA Primary

Addresses

Primary practice location

2509 W March LN
Suite 250
Stockton, CA 95207-8252

Mailing address

P.O. Box 1090
Lodi, CA 95241-1090
Phone (209) 334-1800

Other identifiers 2

IdentifierTypeStateIssuer
00A234500MedicaidCA
1386636165OtherCAGROUP NPI

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

LicenseStateTypeSpecialty
A23450CAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1811962145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1090",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952411090",
            "telephone_number": "209-334-1800",
            "fax_number": "209-334-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 W MARCH LN",
            "address_2": "SUITE 250",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952078252",
            "telephone_number": "209-957-1000",
            "fax_number": "209-957-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STREETER",
        "first_name": "THOMAS",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A23450",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A23450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A234500",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1386636165",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.

Verify at the official NPI Registry.