Lone Tree Medical Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A15858 Issued in CA

Legal business name

LONE TREE MEDICAL CLINIC INC

Practice address

6440 Brentwood Blvd
Suite a
Brentwood, CA 94513

Phone

(925) 634-3513

Fax

(925) 634-7545

NPI assigned

Jul 21, 2006

Organization subpart

No

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

Authorized official

Name

Abe Kaplan, MD

Title

Chief Executive Officer

Phone

(925) 634-3513

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1336160811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 487",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "94513",
            "telephone_number": "925-634-3513",
            "fax_number": "925-634-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 BRENTWOOD BLVD",
            "address_2": "SUITE A",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "94513",
            "telephone_number": "925-634-3513",
            "fax_number": "925-634-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONE TREE MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "KAPLAN",
        "authorized_official_first_name": "ABE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "925-634-3513",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A15858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.