Organization Active NPI

Gary D. Yaeger, D.C., Inc

  • Health Service Clinic/Center
  • Walnut Creek, CA
National Provider Identifier
1417156258
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
DC 23434 Issued in CA
Legal business name
GARY D. YAEGER, D.C., INC
Practice address
3100 Oak Rd
Ste. 120
Walnut Creek, CA 94597-7746
Phone
(925) 947-0188
Fax
(925) 947-0188
NPI assigned
Jul 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Authorized official

Name
Dr. Gary D.. Yaeger, D.C.NPI 1952498123
Title
Owner
Phone
(925) 947-0188

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
Health Service Clinic/Center 261QH0100X DC 23434 CA Primary

Addresses

Primary practice location

3100 Oak Rd
Ste. 120
Walnut Creek, CA 94597-7746

Mailing address

3100 Oak Rd
Ste. 120
Walnut Creek, CA 94597-7746
Phone (925) 947-0188

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070822001097 CA Part B Supplier - Clinic/Group Practice 8628160637 Receives reassigned benefits from 1 practitioner
Practice locations: Walnut Creek, CA

National Provider Directory

National Provider Directory

Locations

1875 Olympic Blvd
Ste 150
Walnut Creek, CA 94596
Phone (510) 243-2130

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": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198800000000",
    "number": "1417156258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 OAK RD",
            "address_2": "STE. 120",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945977746",
            "telephone_number": "925-947-0188",
            "fax_number": "925-947-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 OAK RD",
            "address_2": "STE. 120",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945977746",
            "telephone_number": "925-947-0188",
            "fax_number": "925-947-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY D. YAEGER, D.C., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2007-12-28",
        "status": "A",
        "authorized_official_last_name": "YAEGER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D..",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-947-0188",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "DC 23434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.