Organization
DIABLO VALLEY PRIMARY CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHINNAVUTH PITOU DE MONTEIRO M.D. (OWNER)
(925) 687-5210
Entity
Organization
Contact information
Practice address
2415 HIGH SCHOOL AVE, SUITE 800, CONCORD, CA 94520-1800
(925) 687-5210
(925) 687-5091
Mailing address
2415 HIGH SCHOOL AVE, SUITE 800, CONCORD, CA 94520-1800
(925) 687-5210
(925) 687-5091
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G66708
CA
207R00000X
Internal Medicine Physician
Primary
G73896
CA
363LP2300X
Primary Care Nurse Practitioner
NP14287
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093815540
NPI
CA
01
—
1275642910
NPI
CA
01
—
1558392449
NPI
CA
Enumeration date
10/20/2010
Last updated
10/20/2010
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