Unknown Individual – Rheumatology Physician, NPI 1396748158

Unknown Individual is a healthcare provider. based in Walnut creek, California. specializing in Rheumatology Physician. They hold a License No. A40735 (CA). The NPI Number for Unknown Individual is 1396748158

Main info

Organization
Inactive
51 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1396748158
Phone
(925) 210-1050
Address
120 LA CASA VIA
Deactivation Date
26 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9252101050
Graduation Year
1975 (51 years ago)
PAC ID
3678551561
Group Practice PAC ID
1355329244
Professional Enrollment ID
I20050926001141
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

  • La Casa Via, Walnut Creek, Contra Costa County, California, 95498, United States

    STE 204

    WALNUT CREEK, CA 945983007

    Phone: (925) 210-1050

    Fax: (925) 210-1082

    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)

CMS reports 13 Open Payments records for all available years, with a total value of $788.

Total Amount is formed as General ($788) + Research ($0) + Ownership ($0) = $788.

Last reported payment date: 2024-07-30 • Largest payer in this snapshot: Amgen Inc. ($268).

Total Amount

$788

General + Research + Ownership

Payments

13

Total payment records

General Amount

$788

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-30

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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 94598)

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Provider's Procedures

Unknown Individual performs procedures in Rheumatology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
RHEUMATOLOGYCA96415Infusion of chemotherapy into a vein41881

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: 1355329244View full group profile
NameSpecialtyState
Rheumatology, Internal MedicineCA
R H E U M A T O L O G YCA
R H E U M A T O L O G YIL
R H E U M A T O L O G YCA
R H E U M A T O L O G YIL
R H E U M A T O L O G YCA
-CA

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1396748158 in the public NPI dataset.
Why might Unknown Individual appear inactive while still practicing?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's primary classification?
Rheumatology Physician is the headline specialty for Unknown Individual here. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect Walnut Creek, California as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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