Unknown Individual – Family Medicine Physician, NPI 1407855596

Unknown Individual is a healthcare provider. based in Oakland, California. specializing in Family Medicine Physician. They hold a License No. C31211 (CA). The NPI Number for Unknown Individual is 1407855596

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1407855596
Phone
(510) 658-7660
Address
6105 SAN PABLO AVE
Deactivation Date
1 June 2024
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

  • 6105, San Pablo Avenue, Golden Gate, Oakland, Alameda County, California, 94608, United States

    OAKLAND, CA 946082225

    Phone: (510) 658-7660

    Fax: (510) 658-5138

    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 94608)

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Reviews

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Frequently asked questions

Can I cross-check Unknown Individual using NPI 1407855596?
NPI 1407855596 belongs to Unknown Individual; compare other details if you need extra assurance.
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 Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual located near Oakland?
Unknown Individual currently maps to Oakland, California in this extract.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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