Tri Valley Gastroenterology Medical Center, Inc.

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

Legal business name

TRI VALLEY GASTROENTEROLOGY MEDICAL CENTER, INC.

Practice address

5801 Norris Canyon Rd
Ste. 230
San Ramon, CA 94583

Phone

(925) 275-9966

Fax

(925) 275-9823

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

David T. Wong, M.D.

Title

President

Phone

(925) 275-9966

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tri Valley Gastroenterology Other name

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1891706669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 NORRIS CANYON RD",
            "address_2": "STE. 230",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "94583",
            "telephone_number": "925-275-9966",
            "fax_number": "925-275-9823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 NORRIS CANYON RD",
            "address_2": "STE. 230",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "94583",
            "telephone_number": "925-275-9966",
            "fax_number": "925-275-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI VALLEY GASTROENTEROLOGY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-275-9966",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "ZZZ57371Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri Valley Gastroenterology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Gastroenterology Physician in San Ramon, CA
• Providers in San Ramon, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.