Unknown Individual – Pulmonary Disease Physician, NPI 1073609780

Unknown Individual is a healthcare provider. based in Daly city, California. specializing in Pulmonary Disease Physician. They hold a License No. G25224 (CA). The NPI Number for Unknown Individual is 1073609780

Main info

Organization
Inactive
54 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1073609780
Phone
(650) 991-2381
Address
1800 SULLIVAN AVE RM 304
Deactivation Date
16 May 2023

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
6509912381
Graduation Year
1972 (54 years ago)
PAC ID
0941360416
Professional Enrollment ID
I20081114000091
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1800 SULLIVAN AVE RM 304

    DALY CITY, CA 940152223

    Phone: (650) 991-2381

    Fax: (650) 991-7317

    Type: Location

  • Daly Court, Oakwood, Hoppers Crossing, Melbourne, City of Wyndham, Victoria, 3029, Australia

    DALY CITY, CA 940172180

    Phone: (650) 991-2381

    Fax: (650) 991-7317

    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

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 94015)

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Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1073609780.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Pulmonary Disease Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Does Unknown Individual list a practice location?
Patients near Daly City, California may find Unknown Individual in results; validate coverage separately.
Is the information about Unknown Individual up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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