| Diablo Valley Primary Care, Inc. | |
|
2415 High School Ave Suite 800 Concord CA 94520-1800 | |
| (925) 687-5210 | |
| (925) 687-5091 |
| Full Name | Diablo Valley Primary Care, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2415 High School Ave, Concord, California |
| Authorized Official Name and Position | Chinnavuth Pitou De Monteiro (OWNER) |
| Authorized Official Contact | 9256875210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diablo Valley Primary Care, Inc. 2415 High School Ave Suite 800 Concord CA 94520-1800 Ph: (925) 687-5210 | Diablo Valley Primary Care, Inc. 2415 High School Ave Suite 800 Concord CA 94520-1800 Ph: (925) 687-5210 |
| NPI Number | 1073823332 |
|---|---|
| Provider Enumeration Date | 10/20/2010 |
| Last Update Date | 10/20/2010 |
| Medicare PECOS PAC ID | 9638368921 |
|---|---|
| Medicare Enrollment ID | O20110119000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073823332 | NPI | - | NPPES |
| 1558392449 | Other | CA | NPI |
| 1275642910 | Other | CA | NPI |
| 1093815540 | Other | CA | NPI |
| Provider Name | Chinnavuth De Monteiro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558392449 PECOS PAC ID: 7719920602 Enrollment ID: I20050601001055 |
| Provider Name | Alison Nicole Daugherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013519685 PECOS PAC ID: 9032520267 Enrollment ID: I20201119001502 |
| Provider Name | Jacqueline Athens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568132967 PECOS PAC ID: 2860899267 Enrollment ID: I20210928002400 |
| Provider Name | Tracy Vuong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841878246 PECOS PAC ID: 7810361813 Enrollment ID: I20230314001826 |
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