Diablo Valley Primary Care, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G73896 Issued in CA

Legal business name

DIABLO VALLEY PRIMARY CARE, INC.

Practice address

2415 High School Ave
Suite 800
Concord, CA 94520-1800

Phone

(925) 687-5210

Fax

(925) 687-5091

NPI assigned

Oct 20, 2010

Last updated

Oct 20, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Chinnavuth Pitou De Monteiro, M.D.NPI 1558392449

Title

Owner

Phone

(925) 687-5210

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 15

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.

• Chinnavuth Pitou De Monteiro, M.D.

  • Internal Medicine Physician
  • Concord, CA
  • NPI 1558392449
  Medicare reassignment NPD Authorized official
• Jacqueline Marie Athens, NP

  • Nurse Practitioner
  • Stanford, CA
  • NPI 1568132967

  Primary Care

  Medicare reassignment NPD
• Alison Nicole Daugherty, NP-C

  • Primary Care Nurse Practitioner
  • San Ramon, CA
  • NPI 1013519685
  Medicare reassignment NPD
• Michelle Freed, FNP-C

  • Family Nurse Practitioner
  • Hayward, CA
  • NPI 1710687017
  Medicare reassignment NPD
• Cindy Bik Yu Mai, PA

  • Physician Assistant
  • Concord, CA
  • NPI 1043010622
  Medicare reassignment NPD
• Leah Marie Sparks, NP

  • Family Nurse Practitioner
  • Concord, CA
  • NPI 1730971706
  Medicare reassignment NPD
• Tracy Vuong, NP

  • Family Nurse Practitioner
  • Concord, CA
  • NPI 1841878246

  Family Medicine

  Medicare reassignment NPD
• Michelle Claudette Carter, PA-C

  • Physician Assistant
  • Concord, CA
  • NPI 1427890656
  Medicare reassignment
• Marla D Hall, PA

  • Physician Assistant
  • Concord, CA
  • NPI 1790896967
  Medicare reassignment
• Jasbeen Kaur Rakkar

  • Physician Assistant
  • Napa, CA
  • NPI 1215657846
  Medicare reassignment
• Kamylli J Mendive, PA-C

  • Physician Assistant
  • Tigard, OR
  • NPI 1821653254

  CA

  Medicare reassignment
• Kimberly Bean, FNP

  • Family Nurse Practitioner
  • Concord, CA
  • NPI 1104791672
  NPD

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1073823332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 HIGH SCHOOL AVE",
            "address_2": "SUITE 800",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945201800",
            "telephone_number": "925-687-5210",
            "fax_number": "925-687-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 HIGH SCHOOL AVE",
            "address_2": "SUITE 800",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945201800",
            "telephone_number": "925-687-5210",
            "fax_number": "925-687-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABLO VALLEY PRIMARY CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "DE MONTEIRO",
        "authorized_official_first_name": "CHINNAVUTH",
        "authorized_official_middle_name": "PITOU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-687-5210",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP14287",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G66708",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G73896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093815540",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1558392449",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1275642910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kendall Dials
• Angel Diamond
• Jaye Christopher Diamond
• Mekhayla Diaw

• Internal Medicine Physician in Concord, CA
• Providers in Concord, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.