Active NPI
Randeep K Mavi, M.D.
- Family Medicine Physician
- Walnut Creek, CA
National Provider Identifier
1114158086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- A130210
- Practice address
- 1450 Treat Blvd
Suite 160
Walnut Creek, CA 94597-2168 - Phone
- (925) 296-9000
- Fax
- (925) 296-9071
- NPI assigned
- Jul 27, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301094259 | MI | |
| Family Medicine Physician | 207Q00000X | A130210 | CA | Primary |
Addresses
Primary practice location
1450 Treat Blvd
Suite 160
Walnut Creek, CA 94597-2168
Mailing address
Dept 34929
P.O. Box 39000
San Francisco, CA 94139-0001
Phone (925) 952-2828
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 320035325 | Other | MI | TAX ID |
| P01500109 | Other | CA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130210 | CA | MD | Marriage & Family Therapist |
| A130210 | CA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Muir Health | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Hospital Unit
- Walnut Creek, CA
- NPI 1447269303
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447113600000",
"number": "1114158086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT 34929",
"address_2": "P.O. BOX 39000",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941390001",
"telephone_number": "925-952-2828",
"fax_number": "925-952-2850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 TREAT BLVD",
"address_2": "SUITE 160",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945972168",
"telephone_number": "925-296-9000",
"fax_number": "925-296-9071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAVI",
"first_name": "RANDEEP",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-27",
"last_updated": "2015-11-10",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301094259",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A130210",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "320035325",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01500109",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.