Associated Family Physicians of Vallejo

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G67566 Issued in CA

Legal business name

ASSOCIATED FAMILY PHYSICIANS OF VALLEJO

Practice address

100 Hospital Dr
#304
Vallejo, CA 94589-2580

Phone

(707) 643-6483

Fax

(707) 643-3028

NPI assigned

Apr 1, 2006

Organization subpart

No

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

Authorized official

Name

Sean Patrick Hennessey, MD

Title

President Owner

Phone

(707) 643-6483

Specialties & licenses 3

Addresses

Other names 1

• Associated Family Physicians Medical Group of Vallejo-Benica Inc Doing business as

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

{
    "created_epoch": "1143849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273622400000",
    "number": "1801857396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "address_2": "#304",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892580",
            "telephone_number": "707-643-6483",
            "fax_number": "707-643-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "address_2": "#304",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892580",
            "telephone_number": "707-643-6483",
            "fax_number": "707-643-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED FAMILY PHYSICIANS OF VALLEJO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-01",
        "last_updated": "2010-05-12",
        "status": "A",
        "authorized_official_last_name": "HENNESSEY",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "707-643-6483",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "C41883",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G67566",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G64641",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Associated Family Physicians Medical Group of Vallejo-Benica Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Vallejo, CA
• Providers in Vallejo, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; 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.