NPIMap

Organization Active NPI

University of California Davis Medical Center

  • Medical Specialty Clinic/Center
  • Sacramento, CA
National Provider Identifier
1376767665
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER
Practice address
2521 Stockton Blvd Ste 3110
Sacramento, CA 95817-2207
Phone
(916) 734-1665
Fax
(916) 734-0561
NPI assigned
Apr 11, 2007
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
Mr. Vincent Sam Fong, ACSW 16761NPI 1205182995
Title
Pediatric Social Worker
Phone
(916) 734-1665

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

2521 Stockton Blvd Ste 3110
Sacramento, CA 95817-2207

Mailing address

3304 Monte Vista Ave
Davis, CA 95618
Phone (530) 758-5385

Other identifiers 1

IdentifierTypeStateIssuer
ASW 16761OtherCACLINICAL SOCIAL WORKER

National Provider Directory

National Provider Directory
Tax ID family
Ucd Med GRP Pediatric32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

Locations

2521 Stockton Blvd
Ste 3110
Sacramento, CA 95817
Phone (916) 734-1665

Practitioners & affiliated clinicians

Practitioners 1

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": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376767665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3304 MONTE VISTA AVE",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95618",
            "telephone_number": "530-758-5385",
            "fax_number": "916-734-0561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 STOCKTON BLVD STE 3110",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172207",
            "telephone_number": "916-734-1665",
            "fax_number": "916-734-0561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONG",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "SAM",
        "authorized_official_title_or_position": "PEDIATRIC SOCIAL WORKER",
        "authorized_official_telephone_number": "916-734-1665",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ACSW 16761"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SOCIAL WORKER",
            "identifier": "ASW 16761",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, 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.