Active NPI
Alfredo Quicho Noriega, M.D.
- Surgery Physician
- Vacaville, CA
National Provider Identifier
1912116864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- C42731
- Practice address
- 2100 Peabody Road
Vacaville, CA 95687 - Phone
- (707) 451-0182
- Fax
- (707) 454-3202
- NPI assigned
- May 21, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | C42731 | CA | Primary |
Addresses
Primary practice location
2100 Peabody Road
Vacaville, CA 95687
Mailing address
3217 Corte Granada
Fairfield, CA 94534-7877
Phone (707) 451-0182
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C42731 | CA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Corrections and Rehabilitation-Headquarters | Past | Accepting new patients | |
| State of California Prison Industry Authority | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba California State Prison Pharmacy
- Pharmacy
- Vacaville, CA
- NPI 1124648712
-
- Eyewear Supplier
- Vacaville, CA
- NPI 1588871669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912116864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3217 CORTE GRANADA",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945347877",
"telephone_number": "707-451-0182",
"fax_number": "707-454-3202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 PEABODY ROAD",
"city": "VACAVILLE",
"state": "CA",
"postal_code": "95687",
"telephone_number": "707-451-0182",
"fax_number": "707-454-3202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORIEGA",
"first_name": "ALFREDO",
"middle_name": "QUICHO",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "CA",
"license": "C42731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vacaville, 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.