Individual provider Active NPI

John Raymond Whiteman, M.D.

  • General Practice Physician
  • La Jolla, CA
National Provider Identifier
1063843936
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G35825 Issued in CA
Practice address
2546 Azure Coast Dr
La Jolla, CA 92037-3510
Phone
(858) 922-3750
NPI assigned
Dec 3, 2013
Last updated
Dec 3, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G35825 CA Primary

Addresses

Primary practice location

2546 Azure Coast Dr
La Jolla, CA 92037-3510

Mailing address

2546 Azure Coast Dr
La Jolla, CA 92037-3510
Phone (858) 922-3750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G35825CAMDGeneral Practice Physician

NPI Registry JSON

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

{
    "created_epoch": "1386028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386028800000",
    "number": "1063843936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2546 AZURE COAST DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920373510",
            "telephone_number": "858-922-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2546 AZURE COAST DR",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920373510",
            "telephone_number": "858-922-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEMAN",
        "first_name": "JOHN",
        "middle_name": "RAYMOND",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-12-03",
        "last_updated": "2013-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G35825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; 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.