Active NPI
Salesian High School
- Family Medicine Physician
- Richmond, CA
National Provider Identifier
1659018901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- SALESIAN HIGH SCHOOL
- Practice address
- 2851 Salesian Ave
Richmond, CA 94804-1025 - Phone
- (972) 367-4845
- NPI assigned
- May 18, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mouzon Bass III
- Title
- Administrator/Agent
- Phone
- (972) 367-4845
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary | ||
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X |
Addresses
Primary practice location
2851 Salesian Ave
Richmond, CA 94804-1025
Mailing address
15305 Dallas Pkwy Ste 800
Addison, TX 75001-6415
Phone (972) 367-4845
Other names 1
- SALESIAN HIGH SCHOOL ATHLETICS
National Provider Directory
National Provider DirectoryLocations
2851 Salesian Ave
Richmond, CA 94804
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1652832000000",
"number": "1659018901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15305 DALLAS PKWY STE 800",
"city": "ADDISON",
"state": "TX",
"postal_code": "750016415",
"telephone_number": "972-367-4845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2851 SALESIAN AVE",
"city": "RICHMOND",
"state": "CA",
"postal_code": "948041025",
"telephone_number": "972-367-4845"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SALESIAN HIGH SCHOOL",
"organizational_subpart": "NO",
"enumeration_date": "2022-05-18",
"last_updated": "2022-05-18",
"certification_date": "2022-05-18",
"status": "A",
"authorized_official_last_name": "BASS",
"authorized_official_first_name": "MOUZON",
"authorized_official_title_or_position": "ADMINISTRATOR/AGENT",
"authorized_official_telephone_number": "972-367-4845",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207XX0005X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "SALESIAN HIGH SCHOOL ATHLETICS",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.