Unknown Individual – Orthopaedic Hand Surgery Physician, NPI 1235214909

Unknown Individual is a healthcare provider. based in Fremont, California. specializing in Orthopaedic Hand Surgery Physician. They hold a License No. G55279 (CA). The NPI Number for Unknown Individual is 1235214909

Main info

Organization
Inactive
42 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1235214909
Phone
(510) 793-8754
Address
38162 GLENMOOR DR
Deactivation Date
29 March 2022

Doctor Profile

Medical School Name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Secondary Phone
5107938754
Graduation Year
1984 (42 years ago)
PAC ID
7416005038
Professional Enrollment ID
I20090507000624
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

  • 38162, Glenmoor Drive, Mattos, Fremont, Alameda County, California, 94536, United States

    FREMONT, CA 945366705

    Phone: (510) 793-8754

    Fax: (510) 793-1713

    Mailing address matches the actual address.

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 94536)

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Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1235214909 for Unknown Individual, then check state licensing separately.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Orthopaedic Hand Surgery Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Fremont, California in our summary view.
Why does Unknown Individual have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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