Organization Active NPI

Solano Primary Care Medical Group

  • Family Medicine Physician
  • Vallejo, CA
National Provider Identifier
1083763155
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SOLANO PRIMARY CARE MEDICAL GROUP
Practice address
155 Glen Cove Marina Rd E # 10
Vallejo, CA 94591-7284
Phone
(707) 558-8699
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Fred Bayon, M.D.NPI 1225031362
Title
MD
Phone
(707) 558-8699

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
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

155 Glen Cove Marina Rd E # 10
Vallejo, CA 94591-7284

Mailing address

155 Glen Cove Marina Rd E # 10
Vallejo, CA 94591-7284
Phone (707) 558-8699

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050615001119 CA Part B Supplier - Clinic/Group Practice 3274577606 Receives reassigned benefits from 2 practitioners
Practice locations: Vallejo, CA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2032160Solano Primary Care Medical Group155 Glen Cove Marina Road, Suite 100, Vallejo, CA 94591Provider-performed microscopyNov 3, 2027

National Provider Directory

National Provider Directory

Locations

155 Glen Cove Marina Rd E
Vallejo, CA 94591
Phone (707) 558-8699

155 Glen Cove Marina Rd E
#10
Vallejo, CA 94591
Phone (707) 558-8699

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083763155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 GLEN COVE MARINA RD E # 10",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917284",
            "telephone_number": "707-558-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 GLEN COVE MARINA RD E # 10",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945917284",
            "telephone_number": "707-558-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLANO PRIMARY CARE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAYON",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "707-558-8699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.