NPIMap

Organization Active NPI

Western Bariatric, a Medical Corporation

  • Surgery Physician
  • San Bernardino, CA
National Provider Identifier
1184821373
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
WESTERN BARIATRIC, A MEDICAL CORPORATION
Doing business as
Western Bariatric, A Medical Corporation
Practice address
401 E Highland Ave Ste 351
San Bernardino, CA 92404-3830
Phone
(909) 475-8611
Fax
(909) 475-8668
NPI assigned
Jun 29, 2007
Last updated
Jul 3, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Authorized official

Name
Douglas M Krahn, M.D.NPI 1922029677
Title
President
Phone
(909) 475-8611

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU Primary

Addresses

Primary practice location

401 E Highland Ave Ste 351
San Bernardino, CA 92404-3830

Mailing address

401 E Highland Ave Ste 351
San Bernardino, CA 92404-3830
Phone (909) 475-8611

Other names 1

  • Western Bariatric, A Medical Corporation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090817000247 CA Part B Supplier - Clinic/Group Practice 3476607052 Receives reassigned benefits from 18 practitioners
Practice locations: San Bernardino, CA; Riverside, CA

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1184821373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E HIGHLAND AVE STE 351",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043830",
            "telephone_number": "909-475-8611",
            "fax_number": "909-475-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E HIGHLAND AVE STE 351",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924043830",
            "telephone_number": "909-475-8611",
            "fax_number": "909-475-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN BARIATRIC, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "KRAHN",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-475-8611",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Western Bariatric, A Medical Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.