Campbell & Verducci

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

License

G37227 Issued in CA

Legal business name

CAMPBELL & VERDUCCI

Doing business as

Sonoma Internal Medicine

Practice address

670 3Rd St W
Sonoma, CA 95476-6805

Phone

(707) 938-5916

NPI assigned

Sep 4, 2008

Last updated

Oct 23, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

MEDVANTX, INC.As reported in NPPES

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

Authorized official

Name

Kenny Heine

Title

Director of Operations

Phone

(858) 625-2990

Specialties & licenses 1

Addresses

Other names 1

• Sonoma Internal Medicine Doing business as

Tax ID family

Campbell and Verducci2 organizations share this tax ID, including this one

Part of

Medvantx Inc

Other organizations with this tax ID 1

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

• Campbell & Verducci

  dba Sonoma Internal Medicine

  • Internal Medicine Physician
  • Sonoma, CA
  • NPI 1356419931
  NPD tax ID

Locations

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350950400000",
    "number": "1437307352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 3RD ST W",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766805",
            "telephone_number": "707-938-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPBELL & VERDUCCI",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2008-09-04",
        "last_updated": "2012-10-23",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "G37227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sonoma Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katy Ann Byrne, MFT
• Caliente Springs Physical Therapy Inc
• California Avant-Garde Physicians (Golden Gate Foot and Ankle)
• Gerald Joseph Camarata, MD
• Campbell & Verducci (Sonoma Internal Medicine)
• S Douglas Campbell, MD
• Julie Marie Carlson, D.C.
• James A Carr
• Eliot Adams Carter, D.C.
• Pamela Casacuberta, PHD

• Non-Pharmacy Dispensing Site in Sonoma, CA
• Providers in Sonoma, CA by specialty
• Non-Pharmacy Dispensing Site in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.