Unknown Individual – Dermatology Physician, NPI 1740287960

Unknown Individual is a healthcare provider. based in Burlingame, California. specializing in Dermatology Physician. They hold a License No. A20602 (CA). The NPI Number for Unknown Individual is 1740287960

Main info

Organization
Inactive
64 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1740287960
Phone
(650) 692-0182
Address
1750 EL CAMINO REAL
Deactivation Date
3 April 2025

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Secondary Phone
6506920182
Graduation Year
1962 (64 years ago)
PAC ID
7113091331
Group Practice PAC ID
4082658422
Professional Enrollment ID
I20080806000751
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • El Camino Real, Burlingame, San Mateo County, California, 94101, United States

    STE 206

    BURLINGAME, CA 940103214

    Phone: (650) 692-0182

    Fax: (650) 692-7741

    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 15 Open Payments records for all available years, with a total value of $1,022.

Total Amount is formed as General ($1,022) + Research ($0) + Ownership ($0) = $1,022.

Last reported payment date: 2024-11-08 • Largest payer in this snapshot: ABBVIE INC. ($785).

Total Amount

$1,022

General + Research + Ownership

Payments

15

Total payment records

General Amount

$1,022

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-08

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$785
Allergan, Inc.$237
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 94010)

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Provider's Procedures

Unknown Individual performs procedures in Dermatology Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
DERMATOLOGYCA11101Biopsy of each additional growth of skin and/or tissue2522

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: 4082658422View full group profile
NameSpecialtyState
D E R M A T O L O G YCA
D E R M A T O L O G YCA
D E R M A T O L O G YCA
D E R M A T O L O G YCA
-CA

Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1740287960 as the unique 10-digit identifier.
Does inactive status mean Unknown Individual stopped practicing?
Inactive registry status can reflect deactivation, consolidation, or data lag.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Dermatology Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Burlingame, California.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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