NPIMap

Organization Active NPI

Diablo Valley Women OB,GYN Medical Group Inc.

  • Obstetrics & Gynecology Physician
  • Concord, CA
National Provider Identifier
1609916790
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
DIABLO VALLEY WOMEN OB,GYN MEDICAL GROUP INC.
Practice address
2299 Bacon St
Suite 1
Concord, CA 94520-2050
Phone
(925) 676-3450
Fax
(925) 676-0615
NPI assigned
Feb 7, 2007
Last updated
Jan 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Dr. Kimberley Ellen Fillmore, M.D.NPI 1588736508
Title
Owner and Physician
Phone
(925) 676-3450

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

2299 Bacon St
Suite 1
Concord, CA 94520-2050

Mailing address

2299 Bacon St
Suite 1
Concord, CA 94520-2050
Phone (925) 676-3450

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ66213ZOtherCABLUE SHIELD

National Provider Directory

National Provider Directory

Locations

2299 Bacon St
Ste 1
Concord, CA 94520
Phone (925) 676-3450

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1609916790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2299 BACON ST",
            "address_2": "SUITE 1",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202050",
            "telephone_number": "925-676-3450",
            "fax_number": "925-676-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 BACON ST",
            "address_2": "SUITE 1",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202050",
            "telephone_number": "925-676-3450",
            "fax_number": "925-676-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABLO VALLEY WOMEN OB,GYN MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "FILLMORE",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_middle_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER AND PHYSICIAN",
        "authorized_official_telephone_number": "925-676-3450",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ66213Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.