Active NPI
Paul M. Sullam, M.D.
- Infectious Disease Physician
- San Francisco, CA
National Provider Identifier
1992807994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- G40795
- Practice address
- 4150 Clement St
Vamc 111W
San Francisco, CA 94121-1545 - Phone
- (415) 221-4810
- Fax
- (415) 750-0502
- NPI assigned
- Sep 1, 2006
- 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 |
|---|---|---|---|---|
| Infectious Disease Physician | 207RI0200X | G40795 | CA | Primary |
Addresses
Primary practice location
4150 Clement St
Vamc 111W
San Francisco, CA 94121-1545
Mailing address
4150 Clement St
Vamc 111W
San Francisco, CA 94121-1545
Phone (415) 221-4810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G40795 | CA | MD | Infectious Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992807994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4150 CLEMENT ST",
"address_2": "VAMC 111W",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941211545",
"telephone_number": "415-221-4810",
"fax_number": "415-750-0502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4150 CLEMENT ST",
"address_2": "VAMC 111W",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941211545",
"telephone_number": "415-221-4810",
"fax_number": "415-750-0502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLAM",
"first_name": "PAUL",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "CA",
"license": "G40795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.