Individual provider Active NPI

Bronwyn Sing, D.O.

  • Family Medicine Physician
  • Vallejo, CA
National Provider Identifier
1962797886
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A14249 Issued in CA
Practice address
365 Tuolumne St
Vallejo, CA 94590-5700
Phone
(707) 469-4640
NPI assigned
Jun 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A14249 CA Primary

Addresses

Primary practice location

365 Tuolumne St
Vallejo, CA 94590-5700

Mailing address

1310 Club Dr
Vallejo, CA 94592-1187
Phone (707) 638-5422

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
I20160331001376 CA Practitioner - General PracticePractitioner - Family Practice 0749412138 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A14249CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Jan 3, 2023 Accepting new patients
Lifelong Medical Care Family Medicine CurrentSince Jan 3, 2023 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1962797886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 CLUB DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945921187",
            "telephone_number": "707-638-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 TUOLUMNE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945905700",
            "telephone_number": "707-469-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SING",
        "first_name": "BRONWYN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-20",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A14249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.