NPIMap

Organization Active NPI

SNF Specialists Medical Corporation

  • Internal Medicine Physician
  • Fairfield, CA
National Provider Identifier
1497265565
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A63219 Issued in CA
Legal business name
SNF SPECIALISTS MEDICAL CORPORATION
Practice address
1255 Travis Blvd
Fairfield, CA 94533-4801
Phone
(707) 864-1056
Fax
(707) 864-1095
NPI assigned
Oct 3, 2017
Last updated
Mar 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Authorized official

Name
Gurpreet Dhugga, MDNPI 1356429161
Title
President
Phone
(707) 864-1095

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
Internal Medicine Physician 207R00000X A63219 CA Primary

Addresses

Primary practice location

1255 Travis Blvd
Fairfield, CA 94533-4801

Mailing address

2300 Henry Ave
Pinole, CA 94564-1714
Phone (707) 864-1056

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171030003464 CA Part B Supplier - Clinic/Group Practice 3678849049 Receives reassigned benefits from 53 practitioners
Practice locations: Fairfield, CA; Fallbrook, CA

National Provider Directory

National Provider Directory

Locations

1255 Travis Blvd
Ste A
Fairfield, CA 94533

600 Alfred Nobel Dr
Hercules, CA 94547
Phone (510) 213-0241

600 Alfred Nobel Dr
Ste A
Hercules, CA 94547
Phone (510) 984-1103

215 Gateway Rd W
Ste 100
Napa, CA 94558

2300 Henry Ave
Pinole, CA 94564
Phone (510) 847-0879

Practitioners & affiliated clinicians

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 53

NPI Registry JSON

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647388800000",
    "number": "1497265565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HENRY AVE",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641714",
            "telephone_number": "707-864-1056",
            "fax_number": "707-864-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 TRAVIS BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334801",
            "telephone_number": "707-864-1056",
            "fax_number": "707-864-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNF SPECIALISTS MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-03",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "DHUGGA",
        "authorized_official_first_name": "GURPREET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-864-1095",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A63219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.