Organization Active NPI

Salesian High School

  • Family Medicine Physician
  • Richmond, CA
National Provider Identifier
1659018901
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
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

Updated by the provider on May 18, 2022

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.