Organization Active NPI

Tri Valley Neurosurgical Medical Group

  • Specialist
  • Fremont, CA
National Provider Identifier
1720205362
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
TRI VALLEY NEUROSURGICAL MEDICAL GROUP
Practice address
39039 Paseo Padre Pkwy
Suite # 207
Fremont, CA 94538-1620
Phone
(510) 790-6317
Fax
(510) 790-6383
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Authorized official

Name
Dr. Desmond Erasmus, M.D
Title
Sole Proprietor
Phone
(510) 790-6317

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

39039 Paseo Padre Pkwy
Suite # 207
Fremont, CA 94538-1620

Mailing address

39039 Paseo Padre Pkwy
Suite # 207
Fremont, CA 94538-1620
Phone (510) 790-6317

Other names 1

  • Desmon Erasmus Doing business as

National Provider Directory

National Provider Directory

Locations

39039 Paseo Padre Pkwy
Ste 207
Fremont, CA 94538
Phone (510) 790-6317

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1720205362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39039 PASEO PADRE PKWY",
            "address_2": "SUITE # 207",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381620",
            "telephone_number": "510-790-6317",
            "fax_number": "510-790-6383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39039 PASEO PADRE PKWY",
            "address_2": "SUITE # 207",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381620",
            "telephone_number": "510-790-6317",
            "fax_number": "510-790-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI VALLEY NEUROSURGICAL MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "ERASMUS",
        "authorized_official_first_name": "DESMOND",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "510-790-6317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Desmon Erasmus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; 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.