1669471835 NPI number — JONATHAN SAVELL, MD., INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669471835 NPI number — JONATHAN SAVELL, MD., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JONATHAN SAVELL, MD., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669471835
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5575 W LAS POSITAS BLVD
Provider Second Line Business Mailing Address:
SUITE 240
Provider Business Mailing Address City Name:
PLEASANTON
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94588-5801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
925-460-5000
Provider Business Mailing Address Fax Number:
925-460-5040

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5575 W. LAS POSITAS BLVD.
Provider Second Line Business Practice Location Address:
SUITE 240
Provider Business Practice Location Address City Name:
PLEASANTON
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94588-5802
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
925-460-5000
Provider Business Practice Location Address Fax Number:
925-460-5040
Provider Enumeration Date:
07/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SAVELL
Authorized Official First Name:
JONATHAN
Authorized Official Middle Name:
LEWIS
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
925-460-5000

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00G160910 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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