Unknown Individual – Cardiovascular Disease Physician, NPI 1356324966

Unknown Individual is a healthcare provider. based in Palo alto, California. specializing in Cardiovascular Disease Physician. They hold a License No. G19528 (CA). The NPI Number for Unknown Individual is 1356324966

Main info

Organization
Inactive
57 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1356324966
Phone
(510) 797-9924
Address
P.O. BOX 10000
Deactivation Date
18 February 2022

Doctor Profile

Medical School Name
COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Secondary Phone
5108866878
Graduation Year
1969 (57 years ago)
PAC ID
9335113810
Group Practice PAC ID
3971699455
Professional Enrollment ID
I20040820000836
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • El Palo, La Felisa, Supía, Alto Occidente, Caldas, Región Andina, Colombia

    PALO ALTO, CA 943030985

    Phone: (510) 797-9924

    Fax: (510) 793-9199

    Type: Mailing

  • 3200, Kearney Street, Fremont, Alameda County, California, 94538, United States

    FREMONT, CA 945382299

    Phone: (510) 490-1222

    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 94303)

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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: 3971699455View full group profile
NameSpecialtyState
ARMIDA FAJARDO (FNP-BC)
Nurse PractitionerCA
DR. NABIL KARIM ABUDAYEH (MD)
Cardiovascular Disease (Cardiology), Internal MedicineCA
JOVIE DE LEON-LUCK (NP)
Nurse PractitionerCA

Reviews

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Frequently asked questions

Can I verify Unknown Individual with an NPI only?
You can start verification with NPI 1356324966 for Unknown Individual, then check state licensing separately.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Cardiovascular Disease Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Palo Alto, 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.