Unknown Individual – Nephrology Physician, NPI 1013029313

Unknown Individual is a healthcare provider. based in San leadnro, California. specializing in Nephrology Physician. They hold a License No. G55369 (CA). The NPI Number for Unknown Individual is 1013029313

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1013029313
Phone
(510) 895-9505
Address
13847 E 14TH STREET
Deactivation Date
26 August 2022

Doctor Profile

Medical School Name
HOWARD UNIVERSITY COLLEGE OF MEDICINE
Secondary Phone
5108959505
Graduation Year
1984 (42 years ago)
PAC ID
8527141415
Professional Enrollment ID
I20110908002099
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 13847 E 14TH STREET

    209

    SAN LEADNRO, CA 94578

    Phone: (510) 895-9505

    Fax: (510) 895-2540

    Type: Location

  • 13847;13889;13899;13901, East 14th Street, San Leandro, Alameda County, California, 94577, United States

    209

    SAN LEANDRO, CA 94578

    Phone: (510) 895-9505

    Fax: (510) 895-2540

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

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Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 94578)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1013029313?
NPI 1013029313 belongs to Unknown Individual; compare other details if you need extra assurance.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with Nephrology Physician in the directory — Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near San Leadnro?
Unknown Individual currently maps to San Leadnro, California in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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