Individual provider Active NPI

Stephen D Mulder, M.D.

  • Anesthesiology Physician
  • Templeton, CA
National Provider Identifier
1962429852
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
G47897 Issued in CA
Practice address
1100 Las Tablas Rd
Templeton, CA 93465-9704
Phone
(805) 434-3500
NPI assigned
Jul 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X G47897 CA Primary

Addresses

Primary practice location

1100 Las Tablas Rd
Templeton, CA 93465-9704

Mailing address

PO Box 605
Templeton, CA 93465-0605
Phone (805) 434-1375

Other identifiers 3

IdentifierTypeStateIssuer
770385840OtherCABLUE CROSS OF CALIFORNIA
GR0065000MedicaidCA
ZZZ46801ZOtherCABLUE SHIELD OF CALIFORNIA

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
I20100929000507 CA Practitioner - Anesthesiology 5395861124 Practice locations: Templeton, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47897CAMDMarriage & Family Therapist
G47897CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shaun Lea Certified Registered Nursing Anesthetist, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962429852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 605",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934650605",
            "telephone_number": "805-434-1375",
            "fax_number": "805-434-1716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAS TABLAS RD",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659704",
            "telephone_number": "805-434-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULDER",
        "first_name": "STEPHEN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G47897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF CALIFORNIA",
            "identifier": "770385840",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0065000",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ46801Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

Verify at the official NPI Registry.