Organization Active NPI

Solano Family Physicans Medical Group Professional Corporation

  • Family Medicine Physician
  • American Canyon, CA
National Provider Identifier
1053429969
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00A0627550 Issued in CA
Legal business name
SOLANO FAMILY PHYSICANS MEDICAL GROUP PROFESSIONAL CORPORATION
Practice address
3431 Broadway St
Suite a-8
American Canyon, CA 94503-1228
Phone
(707) 645-7229
Fax
(707) 645-7431
NPI assigned
Aug 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Authorized official

Name
Dr. Kenneth Richard Brooks, M.D.
Title
President/Ceo
Phone
(707) 645-7229

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 00A0627550 CA Primary

Addresses

Primary practice location

3431 Broadway St
Suite a-8
American Canyon, CA 94503-1228

Mailing address

3431 Broadway St
Suite a-8
American Canyon, CA 94503-1228
Phone (707) 645-7229

National Provider Directory

National Provider Directory

Locations

1100 Rose Dr
Ste 110
Benicia, CA 94510

Practitioners & affiliated clinicians

Practitioners 2

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": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325116800000",
    "number": "1053429969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3431 BROADWAY ST",
            "address_2": "SUITE A-8",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945031228",
            "telephone_number": "707-645-7229",
            "fax_number": "707-645-7431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3431 BROADWAY ST",
            "address_2": "SUITE A-8",
            "city": "AMERICAN CANYON",
            "state": "CA",
            "postal_code": "945031228",
            "telephone_number": "707-645-7229",
            "fax_number": "707-645-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLANO FAMILY PHYSICANS MEDICAL GROUP PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2011-12-29",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "707-645-7229",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "00A0627550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Canyon, CA

Sources for this page

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