NPIMap

Organization Active NPI

Paul R Holland MD Inc

  • Ophthalmology Physician
  • Daly City, CA
National Provider Identifier
1851521603
Registry record updated Apr 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A108512 Issued in CA
Legal business name
PAUL R HOLLAND MD INC
Practice address
2171 Junipero Serra Blvd
Ste 100
Daly City, CA 94014-1906
Phone
(650) 758-2171
Fax
(650) 994-0161
NPI assigned
Jul 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2010

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

Authorized official

Name
Dr. Paul Reginald Holland, MDNPI 1205809647
Title
President
Phone
(434) 566-5441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X A108512 CA Primary

Addresses

Primary practice location

2171 Junipero Serra Blvd
Ste 100
Daly City, CA 94014-1906

Mailing address

2171 Junipero Serra Blvd
Ste 100
Daly City, CA 94014-1906
Phone (650) 758-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090728000146 CA Part B Supplier - Clinic/Group Practice 0042363806 Receives reassigned benefits from 1 practitioner
Practice locations: Daly City, CA

National Provider Directory

National Provider Directory

Locations

2171 Junipero Serra Blvd
Ste 100
Daly City, CA 94014
Phone (650) 758-2171

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1247529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271289600000",
    "number": "1851521603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2171 JUNIPERO SERRA BLVD",
            "address_2": "STE 100",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940141906",
            "telephone_number": "650-758-2171",
            "fax_number": "650-994-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2171 JUNIPERO SERRA BLVD",
            "address_2": "STE 100",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940141906",
            "telephone_number": "650-758-2171",
            "fax_number": "650-994-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL R HOLLAND MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-14",
        "last_updated": "2010-04-15",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "REGINALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "434-566-5441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A108512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.