Watt Avenue Medical Clinic

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A41114 Issued in CA

Legal business name

WATT AVENUE MEDICAL CLINIC

Practice address

5710 Watt Ave
North Highlands, CA 95660-4752

Phone

(916) 344-8866

Fax

(916) 344-3979

NPI assigned

Jul 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nourollah Danialypour, M.D.

Title

Owner

Phone

(916) 344-8866

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathleen Saelee

  • Behavior Technician
  • North Highlands, CA
  • NPI 1790252518
  NPD (past)

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1124218979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 WATT AVE",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956604752",
            "telephone_number": "916-344-8866",
            "fax_number": "916-344-3979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5710 WATT AVE",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956604752",
            "telephone_number": "916-344-8866",
            "fax_number": "916-344-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATT AVENUE MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-27",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "DANIALYPOUR",
        "authorized_official_first_name": "NOUROLLAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-344-8866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "A41114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "GR0103750",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1245304856",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walmart Inc.
• Erika Nicole Ward, ANP
• Marilyn A Washington
• Wyzell Washington
• Tina Lou Watson, BSW
• Wellspace Health
• Wellspace Health
• West Coast Pharmacy, Inc.
• Anthony Howard White Jr.
• Justin Williams

• General Practice Physician in North Highlands, CA
• Providers in North Highlands, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; 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.