NPIMap

Organization Active NPI

Contra Costa ENT Medical Assoc

  • Otolaryngology Physician
  • Concord, CA
National Provider Identifier
1013007889
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CONTRA COSTA ENT MEDICAL ASSOC
Practice address
2700 Grant St
Suite 104
Concord, CA 94520
Phone
(925) 685-7400
Fax
(925) 685-0917
NPI assigned
Oct 13, 2006
Last updated
Sep 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Randall K Wenokur, MDNPI 1669562427
Title
Owner Physician
Phone
(825) 685-7400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

2700 Grant St
Suite 104
Concord, CA 94520

Mailing address

2700 Grant Street
Suite 104
Concord, CA 94520
Phone (925) 685-7400

National Provider Directory

National Provider Directory

Locations

1181 Central Blvd
Brentwood, CA 94513

2400 Balfour Rd
Ste 925308
Brentwood, CA 94513

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314921600000",
    "number": "1013007889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 GRANT STREET",
            "address_2": "SUITE 104",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94520",
            "telephone_number": "925-685-7400",
            "fax_number": "925-685-0917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 GRANT ST",
            "address_2": "SUITE 104",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94520",
            "telephone_number": "925-685-7400",
            "fax_number": "925-685-0917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTRA COSTA ENT MEDICAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2011-09-02",
        "status": "A",
        "authorized_official_last_name": "WENOKUR",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "825-685-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.