Provider Demographics
NPI:1235270489
Name:GASTROENTEROLOGY ASSOCIATES OF NAPA VALLEY
Entity Type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES OF NAPA VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAFTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-257-0447
Mailing Address - Street 1:3443 VILLA LN
Mailing Address - Street 2:SUITE 4
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6417
Mailing Address - Country:US
Mailing Address - Phone:707-257-0447
Mailing Address - Fax:707-257-1328
Practice Address - Street 1:3443 VILLA LN
Practice Address - Street 2:SUITE 4
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6417
Practice Address - Country:US
Practice Address - Phone:707-257-0447
Practice Address - Fax:707-257-1328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG56990207RG0100X
CAG025327207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0101750Medicaid
CAZZZ01794ZMedicare ID - Type Unspecified
CAGR0101750Medicaid
CAA02546Medicare UPIN