Withrow Out a Trace Ministyr

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

RW2056 Issued in CA

Legal business name

WITHROW OUT A TRACE MINISTYR

Practice address

2110 Artesia Blvd
Redondo Beach, CA 90278-3073

Phone

(310) 569-5868

NPI assigned

Apr 3, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Vincent M Dugan, REGISTER COUNSELOR

Title

Counselor

Phone

(213) 880-9242

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238716800000",
    "number": "1235371352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 W 137TH ST",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902507340",
            "telephone_number": "310-569-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783073",
            "telephone_number": "310-569-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITHROW OUT A TRACE MINISTYR",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-03",
        "last_updated": "2009-04-03",
        "status": "A",
        "authorized_official_last_name": "DUGAN",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "213-880-9242",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "REGISTER COUNSELOR"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "RW2056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy Jo Winston-Hillier, LMFT
• Carol Gulyas Wintrode, LMFT
• Glen Wishon, M.D.
• Athur L. Wisot, M.D.
• Abigail Withee, MFT
• Jennifer Djie Witkowski, O.D.
• Madeline Elaine Witthuhn, AMFT
• Joshua Wohlgemuth, D.D.S.
• Carolyn Wolfe, SLPA
• Mara Joanna Wolfsen, LCSW

• Health Maintenance Organization in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; 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.