Active NPI
Randal J. Pinnelli, P.A.
- Physician Assistant
- Stockton, CA
National Provider Identifier
1982786570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12921
- Practice address
- 701 E Channel St
Stockton, CA 95202-2628 - Phone
- (209) 954-7704
- NPI assigned
- Oct 20, 2006
- Last updated
- Mar 1, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12921 | CA | Primary |
Addresses
Primary practice location
701 E Channel St
Stockton, CA 95202-2628
Mailing address
PO Box 779
Stockton, CA 95201-0779
Phone (209) 373-2800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Interoperability endpoints
- randal.pinnelli.p1@direct.cmcentersinc.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330560000000",
"number": "1982786570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 779",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952010779",
"telephone_number": "209-373-2800",
"fax_number": "209-373-2873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 E CHANNEL ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952022628",
"telephone_number": "209-954-7704"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PINNELLI",
"first_name": "RANDAL",
"middle_name": "J.",
"name_prefix": "Mr.",
"credential": "P.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2012-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "12921",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.