Centro Medico del Carmen, a Medical Corporation

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

A52193 Issued in CA

Legal business name

CENTRO MEDICO DEL CARMEN, A MEDICAL CORPORATION

Practice address

303 S Juniper St
Escondido, CA 92025-4924

Phone

(760) 480-9051

Fax

(760) 480-9054

NPI assigned

May 21, 2007

Last updated

Jan 22, 2024By 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. Thomas Lee Watson, M.D.NPI 1104865781

Title

Ceo

Phone

(760) 480-9051

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Centro Medico del Carmen

  • General Practice Physician
  • Moreno Valley, CA
  • NPI 1821532508

  O20060314000710

  Same enrollment

Tax ID family

Centro Medico del Carmen a Medical Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Centro Medico del Carmen, a Medical Corporation

  • Primary Care Clinic/Center
  • Escondido, CA
  • NPI 1093154593
  NPD tax ID

Practitioners 2

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.

• Thomas Lee Watson, M.D.

  • General Practice Physician
  • Escondido, CA
  • NPI 1104865781
  Medicare reassignment Authorized official
• Edwin Haroldo Alvarez, PAC

  • Physician Assistant
  • Menifee, CA
  • NPI 1538573175
  Medicare reassignment NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705881600000",
    "number": "1063621738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 S JUNIPER ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254924",
            "telephone_number": "760-480-9051",
            "fax_number": "760-480-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 S JUNIPER ST",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254924",
            "telephone_number": "760-480-9051",
            "fax_number": "760-480-9054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Washington Ave",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Escondido",
            "state": "CA",
            "postal_code": "920252855",
            "country_code": "US",
            "telephone_number": "760-480-9051",
            "fax_number": "760-480-9054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRO MEDICO DEL CARMEN, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-480-9051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A52193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A521930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teri Ann Cavanagh, LCSW
• Brooke Ann Cavecche
• Christian G. Cazares
• Angelica Centeno-Shreder, MA, CCC-SLP, SLPC
• Centro de Salud de la Comunidad de San Ysidro, Inc. (San Ysidro Health Escondido Family Medicine)
• Centro Medico del Carmen, a Medical Corporation
• Cep America - California (Vituity)
• Cep America - California (Vituity)
• Cep America - Intensivists PC (Vituity)
• Cep America - Neurology PC

• General Practice Physician in Escondido, CA
• Providers in Escondido, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; 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.