Organization
DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA INC
Active
Other names
DaVita Renal Specialists of California Medical Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY GABRIEL MD (PRESIDENT)
(303) 626-6103
Entity
Organization
Contact information
Practice address
1360 BURTON DR, SUITE 160, VACAVILLE, CA 95687-3539
(707) 446-4379
(707) 446-4417
Mailing address
1360 BURTON DR, SUITE 160, VACAVILLE, CA 95687-3557
(707) 466-4379
(707) 446-4417
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA5762
RR RET BOARD MED RR CARR
CA
Enumeration date
03/27/2006
Last updated
01/21/2011
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