Individual provider Active NPI

Robert M Duvoisin, DO

  • Emergency Medicine Physician
  • Redding, CA
National Provider Identifier
1790704419
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
20A6249 Issued in CA
Practice address
2175 Rosaline Ave
Redding, CA 96001-2509
Phone
(530) 225-6000
Fax
(818) 587-2493
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A6249 CA Primary

Addresses

Primary practice location

2175 Rosaline Ave
Redding, CA 96001-2509

Mailing address

PO Box 4419
Woodland Hills, CA 91365-4419
Phone (818) 340-9988

Other identifiers 2

IdentifierTypeStateIssuer
00AX62490MedicaidCA
020A62490OtherCABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A6249CAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hospitalists of Northern California, Inc Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790704419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4419",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913654419",
            "telephone_number": "818-340-9988",
            "fax_number": "818-587-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 ROSALINE AVE",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012509",
            "telephone_number": "530-225-6000",
            "fax_number": "818-587-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVOISIN",
        "first_name": "ROBERT",
        "middle_name": "M",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A6249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX62490",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "020A62490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.