Wettstein Sawan Medical Group Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

WETTSTEIN SAWAN MEDICAL GROUP INC

Practice address

12370 Hesperia Rd
Suite 15
Victorville, CA 92395-7719

Phone

(760) 241-7773

Fax

(760) 241-7793

NPI assigned

May 27, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Peggy Neal

Title

Biller

Phone

(760) 241-7773

Specialties & licenses 1

Addresses

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.

• Sawan Medical Group Inc

  • General Practice Physician
  • Apple Valley, CA
  • NPI 1336471242

  O20050708000869

  Same enrollment

Locations

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263859200000",
    "number": "1194772202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12370 HESPERIA RD",
            "address_2": "SUITE 15",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957719",
            "telephone_number": "760-241-7773",
            "fax_number": "760-241-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12370 HESPERIA RD",
            "address_2": "SUITE 15",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957719",
            "telephone_number": "760-241-7773",
            "fax_number": "760-241-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WETTSTEIN SAWAN MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2010-01-19",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "760-241-7773",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Victorville, CA
• Providers in Victorville, 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 19, 2010; 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.