Carlos R. Vigil, D.O. (a Professional Corporation)

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

20A7446 Issued in CA

Legal business name

CARLOS R. VIGIL, D.O. (A PROFESSIONAL CORPORATION)

Practice address

7974 Haven Ave
Suite 210
Rancho Cucamonga, CA 91730-3052

Phone

(909) 941-0661

Fax

(909) 948-5577

NPI assigned

Jan 8, 2009

Last updated

Jan 8, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan Vigil

Title

Manager

Phone

(909) 941-0661

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carlos R Vigil, DO

  • Internal Medicine Physician
  • Rancho Cucamonga, CA
  • NPI 1366494015
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1003053398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "SUITE 210",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303052",
            "telephone_number": "909-941-0661",
            "fax_number": "909-948-5577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7974 HAVEN AVE",
            "address_2": "SUITE 210",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303052",
            "telephone_number": "909-941-0661",
            "fax_number": "909-948-5577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARLOS R. VIGIL, D.O. (A PROFESSIONAL CORPORATION)",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "VIGIL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "909-941-0661"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "20A7446",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX74460",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.