Southwest Professional Medical Arts

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

C38699 Issued in CA

Legal business name

SOUTHWEST PROFESSIONAL MEDICAL ARTS

Practice address

17868 Hwy 18 #329
Apple Valley, CA 92307

Phone

(760) 946-5177

Fax

(760) 946-5133

NPI assigned

Sep 5, 2007

Last updated

Jun 25, 2008By 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

Dr. Charles TaylorNPI 1578594289

Title

President

Phone

(760) 946-5177

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Charles L Taylor

  • Diagnostic Radiology Physician
  • Apple Valley, CA
  • NPI 1578594289
  NPD (past) Authorized official

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1043404700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17868 HWY 18 #329",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "92307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17868 HWY 18 #329",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "92307",
            "telephone_number": "760-946-5177",
            "fax_number": "760-946-5133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST PROFESSIONAL MEDICAL ARTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-05",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-946-5177",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C38699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C386992",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Diagnostic Radiology Physician in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.