NPIMap

Organization Active NPI

Theodore Affue M D Inc

  • Urology Physician
  • El Centro, CA
National Provider Identifier
1316033459
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
G58320 Issued in CA
Legal business name
THEODORE AFFUE M D INC
Practice address
2061 Ross Ave Ste a&B
El Centro, CA 92243-3687
Phone
(760) 353-8181
Fax
(760) 353-8282
NPI assigned
Oct 5, 2006
Last updated
Oct 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Authorized official

Name
Dr. Theodore AffueNPI 1386674000
Title
President
Phone
(760) 353-8181

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
Urology Physician 208800000X G58320 CA Primary

Addresses

Primary practice location

2061 Ross Ave Ste a&B
El Centro, CA 92243-3687

Mailing address

2061 Ross Ave Ste a
El Centro, CA 92243-3687
Phone (760) 353-8181

Other identifiers 1

IdentifierTypeStateIssuer
00G853200OtherCAMEDI-CAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061228000472 CA Part B Supplier - Clinic/Group Practice 6608876487 Receives reassigned benefits from 1 practitioner
Practice locations: El Centro, CA

National Provider Directory

National Provider Directory

Locations

2061 Ross Ave
Ste A
El Centro, CA 92243
Phone (760) 205-1212

2061 Ross Ave
Ste Ab
El Centro, CA 92243
Phone (760) 353-8181

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759363200000",
    "number": "1316033459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 ROSS AVE STE A",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922433687",
            "telephone_number": "760-353-8181",
            "fax_number": "760-353-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 ROSS AVE STE A&B",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "922433687",
            "telephone_number": "760-353-8181",
            "fax_number": "760-353-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE AFFUE M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A",
        "authorized_official_last_name": "AFFUE",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-353-8181",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "G58320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "00G853200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Centro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2025; 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.