Weston Medical

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

WESTON MEDICAL

Practice address

10694 Magnolia Ave
Riverside, CA 92505-1816

Phone

(951) 335-5230

Fax

(951) 335-5267

NPI assigned

Jun 27, 2024

Organization subpart

No

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

Authorized official

Name

Waylan W Kruse

Title

Owner

Phone

(951) 335-5230

Specialties & licenses 1

Addresses

Other names 1

• Weston Medical Former legal business name

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1295570620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10694 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925051816",
            "telephone_number": "951-335-5230",
            "fax_number": "951-335-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10694 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925051816",
            "telephone_number": "951-335-5230",
            "fax_number": "951-335-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTON MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "KRUSE",
        "authorized_official_first_name": "WAYLAN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-335-5230"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weston Medical",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinic/Center in Riverside, CA
• Providers in Riverside, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.