Unknown Individual – Obstetrics & Gynecology Physician, NPI 1033100250

Unknown Individual is a healthcare provider. based in San francisco, California. specializing in Obstetrics & Gynecology Physician. They hold a License No. G3909 (CA). The NPI Number for Unknown Individual is 1033100250

Main info

Organization
Inactive
49 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1033100250
Phone
(530) 344-5470
Address
PO BOX 45680
Deactivation Date
30 August 2023

Doctor Profile

Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
1977 (49 years ago)
PAC ID
0840254009
Group Practice PAC ID
7517875859
Professional Enrollment ID
I20041117000367
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

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Provider Addresses for Unknown Individual

  • San Francisco, San Vicente, Zapote del Valle, Tlajomulco de Zuñiga, Jalisco, 45672, Mexico

    SAN FRANCISCO, CA 941450680

    Phone: (530) 344-5470

    Fax: (530) 344-5490

    Type: Mailing

  • Marshall Way, Placerville, El Dorado County, California, 95667, United States

    2ND FLOOR

    PLACERVILLE, CA 956675722

    Phone: (530) 344-5470

    Fax: (530) 344-5490

    Type: Location

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.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

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

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 94145)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7517875859View full group profile
NameSpecialtyState
DR. MARK W REDOR (M.D.)
-CA
CAROL MARIE FOLEY (FNP)
-CA
KERRY-ANN ALYSCIA KELLY (MD)
O B S T E T R I C S/ G Y N E C O L O G YCA
TROY S DICKSON (M.D.)
Orthopedic SurgeryCA
PRITPAL S RANDHAWA (MD)
Internal MedicineCA
JULIET LA MERS
Family Practice, Addiction Medicine, Emergency Medicine, Preventive MedicineCA
DR. THOMAS P PRINDIVILLE (M.D.)
G A S T R O E N T E R O L O G YCA
MRS. KRISTIN ANNE NURRE (NP)
Nurse PractitionerCA
MR. L. MARK PAYNE (M.S.)
-CA
MRS. LEE K REA (N.P.)
Nurse PractitionerCA

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1033100250 — the number used across U.S. healthcare to identify this provider.
Can Unknown Individual still bill if the NPI is inactive?
Do not rely on inactive status alone — contact the provider for confirmation.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Unknown Individual?
Travel planning: use San Francisco, California as the reference point for Unknown Individual, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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