Injured Workers Medical Group, Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

INJURED WORKERS MEDICAL GROUP, INC.

Practice address

4600 Campus Dr Ste 108
Newport Beach, CA 92660-1885

Phone

(949) 769-6071

NPI assigned

Aug 22, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Vrijesh Shantanu Tantuwaya, MDNPI 1235134966

Title

President

Phone

(858) 472-1380

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vrijesh Shantanu Tantuwaya, MD

  • Neurological Surgery Physician
  • Poway, CA
  • NPI 1235134966
  NPD Authorized official

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

{
    "created_epoch": "1598054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124630967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14252 CULVER DR STE 295",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926040317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 CAMPUS DR STE 108",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926601885",
            "telephone_number": "949-769-6071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INJURED WORKERS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-22",
        "last_updated": "2020-08-22",
        "certification_date": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TANTUWAYA",
        "authorized_official_first_name": "VRIJESH",
        "authorized_official_middle_name": "SHANTANU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-472-1380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111NX0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Occupational Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.