Organization Active NPI

Diablo Dialysis Access Center a Ca Professional Medical Corp

Doing business as Diablo Dialysis Access Center, Inc.

  • Specialist
  • Concord, CA
National Provider Identifier
1144315276
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
DIABLO DIALYSIS ACCESS CENTER A CA PROFESSIONAL MEDICAL CORP
Doing business as
Diablo Dialysis Access Center, Inc.
Practice address
2222 East St
Ste 305
Concord, CA 94520-2084
Phone
(925) 686-1230
Fax
(925) 686-8443
NPI assigned
Oct 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Authorized official

Name
Mrs. Fawn Hutton
Title
Practice Manager
Phone
(925) 686-0315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

2222 East St
Ste 305
Concord, CA 94520-2084

Mailing address

2222 East St
Ste 305
Concord, CA 94520-2084
Phone (925) 686-1230

Other identifiers 1

IdentifierTypeStateIssuer
GR0105450MedicaidCA

Other names 1

  • Diablo Dialysis Access Center, Inc. Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1144315276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 EAST ST",
            "address_2": "STE 305",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202084",
            "telephone_number": "925-686-1230",
            "fax_number": "925-686-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 EAST ST",
            "address_2": "STE 305",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202084",
            "telephone_number": "925-686-1230",
            "fax_number": "925-686-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABLO DIALYSIS ACCESS CENTER A CA PROFESSIONAL MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "HUTTON",
        "authorized_official_first_name": "FAWN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "925-686-0315",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0105450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diablo Dialysis Access Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.

Verify at the official NPI Registry.