Organization Active NPI

Genesis OB Associates, PC

  • Obstetrics & Gynecology Physician
  • Vallejo, CA
National Provider Identifier
1609305077
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
GENESIS OB ASSOCIATES, PC
Practice address
300 Hospital Dr
Vallejo, CA 94589-2574
Phone
(916) 330-4259
Fax
(916) 357-7054
NPI assigned
Jun 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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

Authorized official

Name
Todd Jacks
Title
Administrator
Phone
(916) 330-4259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

300 Hospital Dr
Vallejo, CA 94589-2574

Mailing address

4944 Windplay Dr Ste 200
El Dorado Hills, CA 95762-9310
Phone (916) 330-5259

National Provider Directory

National Provider Directory

Locations

3941 Park Dr
Ste 20504
El Dorado Hills, CA 95762

NPI Registry JSON

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496880000000",
    "number": "1609305077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4944 WINDPLAY DR STE 200",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629310",
            "telephone_number": "916-330-5259",
            "fax_number": "916-357-7054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 HOSPITAL DR",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892574",
            "telephone_number": "916-330-4259",
            "fax_number": "916-357-7054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS OB ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-08",
        "last_updated": "2017-06-08",
        "status": "A",
        "authorized_official_last_name": "JACKS",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-330-4259"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 8, 2017; 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.