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General NPI Number Information
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NPI Number | 1487699765
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Entity Type | Organization
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Legal Business Name | DAVITA NEPHROLOGY MEDICAL ASSOCIATES OF CALIFORNIA, INC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1524 MCHENRY AVE SUITE 310
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City | MODESTO
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State | CA
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Zip | 95350-4500
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Country | US
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Telephone | 209-492-9301
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Fax | 209-492-9180
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Provider Business Mailing Address
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Address Line | 1832 CENTRE POINT CIR SUITE 106
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City | NAPERVILLE
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State | IL
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Zip | 60563-1438
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Country | US
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Telephone | 630-836-8724
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Fax | 866-594-9002
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ANTHONY E. GABRIEL
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Credential | MD
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Telephone | 310-536-2615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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