Davita Nephrology Medical Associates of Ca Inc

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CA INC

Practice address

125 Ciro Ave
Ste 110
San Jose, CA 95128-1671

Phone

(408) 885-0690

Fax

(408) 885-1503

NPI assigned

Jan 12, 2008

Organization subpart

No

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

Authorized official

Name

Anthony E Gabriel, MD

Title

Owner President

Phone

(408) 885-0690

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• South Bay Kidney and Hypertension Consultants Inc Doing business as

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

{
    "created_epoch": "1200096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1275719932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CIRO AVE",
            "address_2": "STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281671",
            "telephone_number": "408-885-0690",
            "fax_number": "408-885-1503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CIRO AVE",
            "address_2": "STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281671",
            "telephone_number": "408-885-0690",
            "fax_number": "408-885-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-12",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "408-885-0690",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - GROUP",
            "identifier": "ZZZ04539Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275719932",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Bay Kidney and Hypertension Consultants Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Davis
• Scott Davis
• Susan Melanie Davis
• Teresa RS Davis, MS, CF-SLP
• Vanessa Davis
• Catherine Davitt, ATC,PTA,C.E.A.S.II
• Jennifer R Davoudi, CRNA
• Simi Davu, MD
• Srijana Davuluri, M.B.B.S
• Vrushali Bharat Dawda

• Nephrology Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.