NPIMap

Individual provider Active NPI

Caesar Reza Djavaherian, M.D.

  • Emergency Medicine Physician
  • Fairfield, CA
National Provider Identifier
1790760551
Registry record updated Mar 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
A104178 Issued in CA
Practice address
1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone
(707) 646-7800
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 234034 NY
Emergency Medicine Physician 207P00000X A104178 CA Primary

Addresses

Primary practice location

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552

Mailing address

769 Spruce St
Berkeley, CA 94707-2040
Phone (510) 502-4336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080922000228 CA Practitioner - Emergency Medicine 3577654417 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Rochester School of Medicine and Dentistry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northbay Physicians Surgery Center, LLCGroup PAC ID 0042122244, 336 clinicians

Practice addresses (Care Compare)

1200 B Gale Wilson Blvd
Fairfield, CA 94533-3552
Phone (707) 429-3600

Hospital & facility affiliations

  • Northbay Medical Center Hospital, Fairfield, CA, CCN 050367

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Physicians Associates Fremont PC Emergency Medicine CurrentSince Jan 1, 2019 Accepting new patients
Northbay Healthcare Group CurrentSince Dec 1, 2019 Accepting new patients
Emergency Physicians Associates San Jose PC Emergency Medicine CurrentSince Jan 1, 2019 Accepting new patients
Emergency Physicians Associates Overhead Operating Account Dennis Belo Emergency Medicine CurrentSince Dec 1, 2017 Accepting new patients
Northbay Healthcare Group CurrentSince Dec 1, 2019 Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine CurrentSince Jun 15, 2011 Accepting new patients
Solano Gateway Medical Group Inc Emergency Medicine CurrentSince Jul 1, 2008 Accepting new patients
Weill Medical College of Cornell Emergency Medicine Past Accepting new patients
Carbon Health Primary Care of California PC PastSince Jul 20, 2025 Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Locations

1320 Travis Blvd
Ste C
Fairfield, CA 94533
Phone (707) 624-7400

1200 B Gale Wilson Blvd
Fairfield, CA 94533
Phone (707) 429-3600

2000 Mowry Ave
Fremont, CA 94538
Phone (510) 793-6653

9400 No Name Uno
Gilroy, CA 95020
Phone (408) 848-2000

411 Grand Ave
Oakland, CA 94610
Phone (510) 465-3668

2105 Forest Ave
San Jose, CA 95128
Phone (408) 947-2500

225 N Jackson Ave
San Jose, CA 95116
Phone (408) 347-4051

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

1000 Nut Tree Rd
Vacaville, CA 95687
Phone (707) 446-4000

1679 E Monte Vista Ave
Ste 104
Vacaville, CA 95688
Phone (707) 624-7400

Organizations & group practices 12

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300060800000",
    "number": "1790760551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "769 SPRUCE ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947072040",
            "telephone_number": "510-502-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 B GALE WILSON BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333552",
            "telephone_number": "707-646-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJAVAHERIAN",
        "first_name": "CAESAR",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2011-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "234034",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "A104178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.