NPIMap

Organization Active NPI

Davita Nephrology Medical Associates of California, Inc

  • Nephrology Physician
  • Modesto, CA
National Provider Identifier
1487699765
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA, INC
Practice address
1524 McHenry Ave
Suite 310
Modesto, CA 95350-4500
Phone
(209) 492-9301
Fax
(209) 492-9180
NPI assigned
Jun 19, 2006
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
Dr. Anthony E. Gabriel, MD
Title
Owner/President
Phone
(310) 536-2615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1524 McHenry Ave
Suite 310
Modesto, CA 95350-4500

Mailing address

1832 Centre Point Cir
Suite 106
Naperville, IL 60563-1438
Phone (630) 836-8724

Other names 1

  • Modesto Kidney Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davita Nephrology Medical Associates of California Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

Locations

1832 Centre Point Cir
Ste 106
Naperville, IL 60563

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": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487699765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 CENTRE POINT CIR",
            "address_2": "SUITE 106",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605631438",
            "telephone_number": "630-836-8724",
            "fax_number": "866-594-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 MCHENRY AVE",
            "address_2": "SUITE 310",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504500",
            "telephone_number": "209-492-9301",
            "fax_number": "209-492-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GABRIEL",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "310-536-2615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Modesto Kidney Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, 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.