Organization Active NPI

Endocrinology,Metabolism,and Clinical Nutrition Practice

  • Metabolic Nutrition Registered Dietitian
  • San Mateo, CA
National Provider Identifier
1881960797
Registry record updated Mar 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
License
A78806 Issued in CA
Legal business name
ENDOCRINOLOGY,METABOLISM,AND CLINICAL NUTRITION PRACTICE
Practice address
50 S San Mateo Dr
Suite 370
San Mateo, CA 94401-3857
Phone
(650) 347-0063
NPI assigned
Mar 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2012

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

Authorized official

Name
Sumbul Beg, MDNPI 1437127560
Title
Owner
Phone
(650) 373-0919

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
Metabolic Nutrition Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133VN1006X A78806 CA Primary

Addresses

Primary practice location

50 S San Mateo Dr
Suite 370
San Mateo, CA 94401-3857

Mailing address

1325 Howard Ave
No 825
Burlingame, CA 94010-4212
Phone (650) 347-0063

Other identifiers 1

IdentifierTypeStateIssuer
1437127560OtherCANPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120614000792 CA Part B Supplier - Clinic/Group Practice 3870757255 Receives reassigned benefits from 1 practitioner
Practice locations: Burlingame, CA; Fremont, CA

National Provider Directory

National Provider Directory

Locations

1838 El Camino Real
Burlingame, CA 94010
Phone (650) 204-5505

3775 Beacon Ave
Ste 120
Fremont, CA 94538
Phone (510) 794-6633

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1332633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332633600000",
    "number": "1881960797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 HOWARD AVE",
            "address_2": "NO 825",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104212",
            "telephone_number": "650-347-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S SAN MATEO DR",
            "address_2": "SUITE 370",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013857",
            "telephone_number": "650-347-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOCRINOLOGY,METABOLISM,AND CLINICAL NUTRITION PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-25",
        "last_updated": "2012-03-25",
        "status": "A",
        "authorized_official_last_name": "BEG",
        "authorized_official_first_name": "SUMBUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-373-0919",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "CA",
            "license": "A78806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437127560",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2012; 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.