Unknown Individual – Cardiovascular Disease Physician, NPI 1104814722

Unknown Individual is a healthcare provider. based in Chico, California. specializing in Cardiovascular Disease Physician. They hold a License No. C28584 (CA). The NPI Number for Unknown Individual is 1104814722

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1104814722
Phone
(530) 342-0123
Address
198 COHASSET RD
Deactivation Date
30 January 2025
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

  • Cohasset Road, Chico, Butte County, California, 95973, United States

    CHICO, CA 959262202

    Phone: (530) 342-0123

    Fax: (530) 342-6475

    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 95926)

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Reviews

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Frequently asked questions

Is there an official ID for Unknown Individual in U.S. healthcare records?
The official identifier for Unknown Individual is NPI 1104814722.
Who updates status for Unknown Individual?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What area of care is associated with Unknown Individual?
Unknown Individual's record emphasizes Cardiovascular Disease Physician. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Chico, California.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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