Organization Active NPI

Solano After Hours Medical Clinic Inc.

  • Family Medicine Physician
  • Fairfield, CA
National Provider Identifier
1922074814
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G36497 Issued in CA
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

Updated by the provider on Aug 22, 2020

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)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.