Active NPI
Solano After Hours Medical Clinic Inc.
- Family Medicine Physician
- Fairfield, CA
National Provider Identifier
1922074814
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- G36497
- Legal business name
- SOLANO AFTER HOURS MEDICAL CLINIC INC.
- Practice address
- 1620 Pennsylvania Ave
Ste C
Fairfield, CA 94533-3551 - Phone
- (707) 428-4878
- Fax
- (707) 428-0806
- NPI assigned
- Feb 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David Roy Gilliam, M.D.
- Title
- Owner
- Phone
- (707) 428-4878
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | G36497 | CA | Primary |
Addresses
Primary practice location
1620 Pennsylvania Ave
Ste C
Fairfield, CA 94533-3551
Mailing address
1620 Pennsylvania Ave
Ste C
Fairfield, CA 94533-3551
Phone (707) 428-4878
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1922074814",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 PENNSYLVANIA AVE",
"address_2": "STE C",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333551",
"telephone_number": "707-428-4878",
"fax_number": "707-428-0806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 PENNSYLVANIA AVE",
"address_2": "STE C",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945333551",
"telephone_number": "707-428-4878",
"fax_number": "707-428-0806"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOLANO AFTER HOURS MEDICAL CLINIC INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-28",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "GILLIAM",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "ROY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "707-428-4878",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "CA",
"license": "G36497",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.