NPIMap

Organization Active NPI

Davita Nephrology Medical Associates of California Inc

  • Nephrology Physician
  • Vacaville, CA
National Provider Identifier
1013977461
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA INC
Practice address
1360 Burton Dr
Suite 160
Vacaville, CA 95687-3539
Phone
(707) 446-4379
Fax
(707) 446-4417
NPI assigned
Mar 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Authorized official

Name
Mr. Anthony Gabriel, MD
Title
President
Phone
(303) 626-6103

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1360 Burton Dr
Suite 160
Vacaville, CA 95687-3539

Mailing address

1360 Burton Dr
Suite 160
Vacaville, CA 95687-3557
Phone (707) 466-4379

Other identifiers 1

IdentifierTypeStateIssuer
DA5762OtherCARR RET BOARD MED RR CARR

Other names 1

  • DaVita Renal Specialists of California Medical Corporation Doing business as

National Provider Directory

National Provider Directory

Locations

650 Empire St
Ste A
Fairfield, CA 94533
Phone (707) 426-5407

125 N Jackson Ave
Ste 109
San Jose, CA 95116
Phone (408) 929-4425

12291 Washington Blvd
Ste 204
Whittier, CA 90606

1049 Clifton St
Ft Worth, TX 76107
Phone (817) 628-0284

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295568000000",
    "number": "1013977461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 BURTON DR",
            "address_2": "SUITE 160",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956873557",
            "telephone_number": "707-466-4379",
            "fax_number": "707-446-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 BURTON DR",
            "address_2": "SUITE 160",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956873539",
            "telephone_number": "707-446-4379",
            "fax_number": "707-446-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2011-01-21",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-626-6103",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR RET BOARD MED RR CARR",
            "identifier": "DA5762",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVita Renal Specialists of California Medical Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.