NPIMap

Organization Active NPI

Douglas F. Carrasco M.D. Inc.

  • Primary Care Clinic/Center
  • Temecula, CA
National Provider Identifier
1295927408
Registry record updated Aug 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
G82091 Issued in CA
Legal business name
DOUGLAS F. CARRASCO M.D. INC.
Practice address
44274 George Cushman CT
Suite 210
Temecula, CA 92592-5945
Phone
(951) 302-4603
Fax
(951) 302-4605
NPI assigned
Aug 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2007

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

Authorized official

Name
Dr. Douglas F. Carrasco, M.D.NPI 1861406340
Title
President
Phone
(951) 566-6766

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
Primary Care Clinic/Center 261QP2300X G82091 CA Primary

Addresses

Primary practice location

44274 George Cushman CT
Suite 210
Temecula, CA 92592-5945

Mailing address

44274 George Cushman CT
Suite 210
Temecula, CA 92592-5945
Phone (951) 302-4603

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080116000431 CA Part B Supplier - Clinic/Group Practice 5092896027 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Murrieta, CA; Temecula, CA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Carrasco Douglas2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

44274 George Cushman Ct
Ste 210
Temecula, CA 92592
Phone (951) 302-4603

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCACCA

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186790400000",
    "number": "1295927408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44274 GEORGE CUSHMAN CT",
            "address_2": "SUITE 210",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925945",
            "telephone_number": "951-302-4603",
            "fax_number": "951-302-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44274 GEORGE CUSHMAN CT",
            "address_2": "SUITE 210",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925945",
            "telephone_number": "951-302-4603",
            "fax_number": "951-302-4605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS F. CARRASCO M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-11",
        "last_updated": "2007-08-11",
        "status": "A",
        "authorized_official_last_name": "CARRASCO",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-566-6766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "G82091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2007; 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.