NPIMap

Organization Active NPI

Davita Nephrology Medical Associates of Ca, Inc.

  • Nephrology Physician
  • Fairfield, CA
National Provider Identifier
1306806740
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CA, INC.
Practice address
650 Empire St
Suite a
Fairfield, CA 94533-5536
Phone
(707) 426-5407
Fax
(707) 426-6376
NPI assigned
Mar 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Authorized official

Name
Dr. Anthony Gabriel, M.D.
Title
President
Phone
(303) 626-6220

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

650 Empire St
Suite a
Fairfield, CA 94533-5536

Mailing address

650 Empire St
Suite a
Fairfield, CA 94533-5536
Phone (707) 426-5407

Other identifiers 1

IdentifierTypeStateIssuer
CJ5764OtherCARAILROAD MEDICARE

Other names 1

  • DaVita Renal Specialists of California Medical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davita Nephrology Medical Associates of California Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

650 Empire St
Fairfield, CA 94533
Phone (707) 426-5407

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": "1143417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295568000000",
    "number": "1306806740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 EMPIRE ST",
            "address_2": "SUITE A",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335536",
            "telephone_number": "707-426-5407",
            "fax_number": "707-426-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 EMPIRE ST",
            "address_2": "SUITE A",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335536",
            "telephone_number": "707-426-5407",
            "fax_number": "707-426-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-27",
        "last_updated": "2011-01-21",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-626-6220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ5764",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DaVita Renal Specialists of California Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.