Organization Active NPI

Ched Nwagwu MD PC

  • Neurological Surgery Physician
  • Mission Viejo, CA
National Provider Identifier
1336794130
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
CHED NWAGWU MD PC
Practice address
26732 Crown Valley Pkwy Ste 541
Mission Viejo, CA 92691-6376
Phone
(949) 388-7190
Fax
(949) 388-7150
NPI assigned
Aug 8, 2019
Last updated
May 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Authorized official

Name
Dr. Ched Nwagwu, MD
Title
President
Phone
(949) 554-5112

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

26732 Crown Valley Pkwy Ste 541
Mission Viejo, CA 92691-6376

Mailing address

31381 Trigo TRL
Trabuco Canyon, CA 92679-3610
Phone (949) 554-5112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230518003114 CA Part B Supplier - Clinic/Group Practice 1153787049 Receives reassigned benefits from 1 practitioner
Practice locations: Mission Viejo, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1565222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1336794130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31381 TRIGO TRL",
            "city": "TRABUCO CANYON",
            "state": "CA",
            "postal_code": "926793610",
            "telephone_number": "949-554-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26732 CROWN VALLEY PKWY STE 541",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916376",
            "telephone_number": "949-388-7190",
            "fax_number": "949-388-7150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHED NWAGWU MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-08",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "NWAGWU",
        "authorized_official_first_name": "CHED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-554-5112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.