NPIMap

Organization Active NPI

Avant Inpatient Services Medical Group, Inc

  • Internal Medicine Physician
  • Castro Valley, CA
National Provider Identifier
1336106897
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G44754 Issued in CA
Legal business name
AVANT INPATIENT SERVICES MEDICAL GROUP, INC
Practice address
20103 Lake Chabot Rd
Castro Valley, CA 94546-5341
Phone
(510) 889-5082
Fax
(510) 733-0878
NPI assigned
Apr 27, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Carol J Jessop, MD
Title
President
Phone
(510) 889-5082

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G44754 CA Primary

Addresses

Primary practice location

20103 Lake Chabot Rd
Castro Valley, CA 94546-5341

Mailing address

PO Box 26529
Santa Ana, CA 92799-6529
Phone (714) 689-1500

Other identifiers 1

IdentifierTypeStateIssuer
GR0087602MedicaidCA

National Provider Directory

National Provider Directory

Locations

5245 College Ave
#642
Oakland, CA 94618

5349 College Ave
Oakland, CA 94618
Phone (510) 409-5222

Practitioners & affiliated clinicians

Practitioners 81

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 81

NPI Registry JSON

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336106897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26529",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927996529",
            "telephone_number": "714-689-1500",
            "fax_number": "714-918-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20103 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465341",
            "telephone_number": "510-889-5082",
            "fax_number": "510-733-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANT INPATIENT SERVICES MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JESSOP",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-889-5082",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G44754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0087602",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.