Organization
DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CA, INC.
Active
Other names
DaVita Renal Specialists of California Medical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY GABRIEL M.D. (PRESIDENT)
(303) 626-6220
Entity
Organization
Contact information
Practice address
650 EMPIRE ST, SUITE A, FAIRFIELD, CA 94533-5536
(707) 426-5407
(707) 426-6376
Mailing address
650 EMPIRE ST, SUITE A, FAIRFIELD, CA 94533-5536
(707) 426-5407
(707) 426-6376
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RN0300X
Nephrology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ5764
RAILROAD MEDICARE
CA
Enumeration date
03/27/2006
Last updated
01/21/2011
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