California Gastroenterology, a Medical Corporation

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

CALIFORNIA GASTROENTEROLOGY, A MEDICAL CORPORATION

Practice address

3108 Ponte Morino Dr
Suite 230
Cameron Park, CA 95682-8278

Phone

(530) 672-2701

NPI assigned

Apr 3, 2008

Last updated

Apr 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Russell F. Jacoby, M.D.NPI 1700852878

Title

President

Phone

(530) 672-2701

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Russell F Jacoby, MD

  • Gastroenterology Physician
  • Cameron Park, CA
  • NPI 1700852878
  Authorized official Same address or phone

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

{
    "created_epoch": "1207180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207180800000",
    "number": "1578736138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3108 PONTE MORINO DR",
            "address_2": "SUITE 230",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828278",
            "telephone_number": "530-672-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 PONTE MORINO DR",
            "address_2": "SUITE 230",
            "city": "CAMERON PARK",
            "state": "CA",
            "postal_code": "956828278",
            "telephone_number": "530-672-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA GASTROENTEROLOGY, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-03",
        "last_updated": "2008-04-03",
        "status": "A",
        "authorized_official_last_name": "JACOBY",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-672-2701",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Katherine Bucon, LCSW
• Bullards Dialysis LLC (Cameron Park Dialysis)
• Connie Kimble Burgeson, MD
• Tamara Ann Cable
• Nicole Cain, AMFT
• Christine L. Cambridge, MD
• Cameo Rcfe Inc
• Cameron Park Community Services District (Cameron Park Fire Department)
• Cameron Park Counseling Center
• Cameron Park Counseling Center, Inc. (Cameron Park Counseling Center)

• Gastroenterology Physician in Cameron Park, CA
• Providers in Cameron Park, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.