Organization Active NPI

William J Padilla a Medical Corporation

  • Family Medicine Physician
  • Chula Vista, CA
National Provider Identifier
1194969956
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A43091 Issued in CA
Legal business name
WILLIAM J PADILLA A MEDICAL CORPORATION
Practice address
263 Church Ave
Chula Vista, CA 91910-2728
Phone
(619) 422-1324
Fax
(619) 422-1055
NPI assigned
Apr 23, 2009
Last updated
Jun 4, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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

Authorized official

Name
William J Padilla, M. D.NPI 1972694792
Title
President
Phone
(619) 422-1324

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A43091 CA Primary

Addresses

Primary practice location

263 Church Ave
Chula Vista, CA 91910-2728

Mailing address

263 Church Ave
Chula Vista, CA 91910-2728
Phone (619) 422-1324

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090820000789 CA Part B Supplier - Clinic/Group Practice 3971657255 Receives reassigned benefits from 2 practitioners
Practice locations: Chula Vista, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D0984471William J Padilla MD, a Medical Corporation263 Church Avenue, Chula Vista, CA 91910Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

263 Church Ave
Chula Vista, CA 91910
Phone (619) 422-1324

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401840000000",
    "number": "1194969956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 CHURCH AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102728",
            "telephone_number": "619-422-1324",
            "fax_number": "619-422-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 CHURCH AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102728",
            "telephone_number": "619-422-1324",
            "fax_number": "619-422-1055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J PADILLA A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-23",
        "last_updated": "2014-06-04",
        "status": "A",
        "authorized_official_last_name": "PADILLA",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-422-1324",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A43091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.