Varner E. Dudley, III, M.D., Inc

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G55075 Issued in CA

Legal business name

VARNER E. DUDLEY, III, M.D., INC

Practice address

1509 Wilson Ter
Glendale, CA 91206-4007

Phone

(818) 409-8000

Fax

(818) 546-5632

NPI assigned

Jan 10, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Varner E. Dudley III, M.D.

Title

President

Phone

(626) 584-1556

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203379200000",
    "number": "1013067578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S LAKE AVE",
            "address_2": "SUITE 535",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911013005",
            "telephone_number": "626-795-6596",
            "fax_number": "626-795-8247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 WILSON TER",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064007",
            "telephone_number": "818-409-8000",
            "fax_number": "818-546-5632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARNER E. DUDLEY, III, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2008-02-19",
        "status": "A",
        "authorized_official_last_name": "DUDLEY",
        "authorized_official_first_name": "VARNER",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-584-1556",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G55075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "00G550750",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G550750",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.