Park Avenue Walk in Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A63401 Issued in CA

Legal business name

PARK AVENUE WALK IN CLINIC

Practice address

1280 Monument Blvd Ste 1
Concord, CA 94520-4405

Phone

(925) 825-8181

Fax

(925) 825-8383

NPI assigned

Jun 29, 2007

Organization subpart

Yes

Parent organization

BUCKWALTER FAMILY MEDICINE LTD.As reported in NPPES

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

Authorized official

Name

Dr. Kevin Buckwalter, MD

Title

Physician Owner

Phone

(925) 825-8181

Specialties & licenses 1

Addresses

Other identifiers 2

Part of

Kevin Buckwalter

Locations

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1942407283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1280 MONUMENT BLVD STE 1",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204405",
            "telephone_number": "925-825-8181",
            "fax_number": "925-825-8383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1280 MONUMENT BLVD STE 1",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945204405",
            "telephone_number": "925-825-8181",
            "fax_number": "925-825-8383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK AVENUE WALK IN CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BUCKWALTER FAMILY MEDICINE LTD.",
        "enumeration_date": "2007-06-29",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "BUCKWALTER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "925-825-8181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A63401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1003813478",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE 2",
            "identifier": "1942407283",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Victoria Paredes
• Smita Gautam Pareek, M.D.
• Parham Gharagozlou MD Inc
• Jade Alexis Parham
• Susan Parish
• Conner Joseph Park
• Sujin Park
• Abreanna Rose Parker
• Catherine Odessa Parker
• Dominique Parker

• Family Medicine Physician in Concord, CA
• Providers in Concord, 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 Sep 1, 2015; 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.