Individual provider Active NPI

J. David Malone, MD

  • Nephrology Physician
  • San Francisco, CA
National Provider Identifier
1952404253
Registry record updated May 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
C43355 Issued in CA
Practice address
909 Hyde Street
Suite 210
San Francisco, CA 94109-4845
Phone
(415) 292-3313
Fax
(415) 415-5635
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X C43355 CA Primary

Addresses

Primary practice location

909 Hyde Street
Suite 210
San Francisco, CA 94109-4845

Mailing address

909 Hyde St Ste 210
San Francisco, CA 94109-4845
Phone (415) 292-3313

Other identifiers 1

IdentifierTypeStateIssuer
00C433550MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040406000885 CA Practitioner - Nephrology 0941293989 Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C43355CAMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525219200000",
    "number": "1952404253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 HYDE ST STE 210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094845",
            "telephone_number": "415-292-3313",
            "fax_number": "415-563-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 HYDE STREET",
            "address_2": "SUITE 210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941094845",
            "telephone_number": "415-292-3313",
            "fax_number": "415-415-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "J. DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2018-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "C43355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C433550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.