Fidel Realyvasquez Jr., M.D.

Primary specialty

Occupational Medicine PhysicianTaxonomy code 2083X0100X

License

G33283 Issued in CA

Practice address

15 Business Park Way Ste 111
Sacramento, CA 95828-0959

Phone

(916) 387-6929

Fax

(916) 387-6977

NPI assigned

Jul 26, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: fidel.realyvasquez@3682.securemail.prognocis.com

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311638400000",
    "number": "1689952590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 BUSINESS PARK WAY STE 111",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958280959",
            "telephone_number": "916-387-6929",
            "fax_number": "916-387-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 BUSINESS PARK WAY STE 111",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958280959",
            "telephone_number": "916-387-6929",
            "fax_number": "916-387-6977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REALYVASQUEZ",
        "first_name": "FIDEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-26",
        "last_updated": "2011-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "CA",
            "license": "G33283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Medicine Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Occupational Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; 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.