Organization Active NPI

Gastro Physicians of California, Inc.

  • Gastroenterology Physician
  • Sacramento, CA
National Provider Identifier
1053071241
Registry record updated Dec 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTRO PHYSICIANS OF CALIFORNIA, INC.
Practice address
2288 Auburn Blvd Ste 101
Sacramento, CA 95821-1619
Phone
(209) 751-7165
NPI assigned
Dec 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2021

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

Authorized official

Name
Dr. Jonathan S Davidson X, MDNPI 1295891224
Title
Ceo
Phone
(209) 751-7165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

2288 Auburn Blvd Ste 101
Sacramento, CA 95821-1619

Mailing address

1658 Citadella Dr
Roseville, CA 95747-5022
Phone (209) 751-7165

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1053071241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1658 CITADELLA DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957475022",
            "telephone_number": "209-751-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 AUBURN BLVD STE 101",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958211619",
            "telephone_number": "209-751-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTRO PHYSICIANS OF CALIFORNIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-751-7165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "X",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.