Relevare Group Incorporated

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A0736012 Issued in CA

Legal business name

RELEVARE GROUP INCORPORATED

Practice address

1287 Fulton Rd
Santa Rosa, CA 95401-4923

Phone

(707) 888-5808

Fax

(707) 577-8315

NPI assigned

Feb 25, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Michael Lee Medvin, M.D.

Title

Owner

Phone

(707) 888-5808

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1396085569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "619-464-1165",
            "fax_number": "619-567-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 FULTON RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014923",
            "telephone_number": "707-888-5808",
            "fax_number": "707-577-8315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELEVARE GROUP INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-25",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "MEDVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-888-5808",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A0736012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; 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.