NPIMap

Organization Active NPI

G Samuel S Chua MD, a Professional Medical Corporation

  • Family Medicine Physician
  • Vallejo, CA
National Provider Identifier
1598917981
Registry record updated Dec 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A49399 Issued in CA
Legal business name
G SAMUEL S CHUA MD, A PROFESSIONAL MEDICAL CORPORATION
Practice address
96 Springstowne Center
Suite B
Vallejo, CA 94591-5566
Phone
(707) 649-2228
Fax
(707) 649-0120
NPI assigned
Oct 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2016

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

Authorized official

Name
Dr. Gabriel Samuel Siy Chua, M.D.
Title
President
Phone
(707) 649-2228

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X A49399 CA Primary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X A41529 CA

Addresses

Primary practice location

96 Springstowne Center
Suite B
Vallejo, CA 94591-5566

Mailing address

96 Springstowne Center
Suite B
Vallejo, CA 94591-5566
Phone (707) 649-2228

Other identifiers 1

IdentifierTypeStateIssuer
00A493990MedicaidCA

Other names 1

  • Springstowne Family Physicians Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481241600000",
    "number": "1598917981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 SPRINGSTOWNE CENTER",
            "address_2": "SUITE B",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945915566",
            "telephone_number": "707-649-2228",
            "fax_number": "707-649-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 SPRINGSTOWNE CENTER",
            "address_2": "SUITE B",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945915566",
            "telephone_number": "707-649-2228",
            "fax_number": "707-649-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G SAMUEL S CHUA MD, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2016-12-09",
        "status": "A",
        "authorized_official_last_name": "CHUA",
        "authorized_official_first_name": "GABRIEL SAMUEL",
        "authorized_official_middle_name": "SIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-649-2228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A49399",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CA",
            "license": "A41529",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A493990",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springstowne Family Physicians",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.