NPIMap

Organization Active NPI

Excellent Anesthesia PC

  • Anesthesiology Physician
  • Walnut, CA
National Provider Identifier
1184941494
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A52501 Issued in CA
Legal business name
EXCELLENT ANESTHESIA PC
Practice address
1260 Pierre Rd
Walnut, CA 91789-1934
Phone
(951) 966-6626
Fax
(909) 594-6607
NPI assigned
Apr 26, 2010
Last updated
Apr 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Authorized official

Name
John O Dimowo, M.D.
Title
President
Phone
(951) 966-6626

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X A52501 CA Primary

Addresses

Primary practice location

1260 Pierre Rd
Walnut, CA 91789-1934

Mailing address

1260 Pierre Rd
Walnut, CA 91789-1934
Phone (951) 966-6626

Other names 1

  • Excellent Anesthesia PC Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1272240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272240000000",
    "number": "1184941494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 PIERRE RD",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917891934",
            "telephone_number": "951-966-6626",
            "fax_number": "909-594-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 PIERRE RD",
            "city": "WALNUT",
            "state": "CA",
            "postal_code": "917891934",
            "telephone_number": "951-966-6626",
            "fax_number": "909-594-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENT ANESTHESIA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-26",
        "last_updated": "2010-04-26",
        "status": "A",
        "authorized_official_last_name": "DIMOWO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-966-6626",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A52501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Excellent Anesthesia PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Walnut, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; 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.