Individual provider Active NPI

Keith R Wresch, M.D.

  • Family Medicine Physician
  • Highland, CA
National Provider Identifier
1346276813
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A90435 Issued in CA
Practice address
7000 Boulder Ave
Highland, CA 92346-3348
Phone
(909) 862-1191
Fax
(909) 796-4158
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A90435 CA Primary

Addresses

Primary practice location

7000 Boulder Ave
Highland, CA 92346-3348

Mailing address

PO Box 2200
Redlands, CA 92373-0722
Phone (909) 793-3311

Other identifiers 1

IdentifierTypeStateIssuer
00A904350MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051101001144 CA Practitioner - Family PracticePractitioner - General PracticePractitioner - Preventive MedicinePractitioner - Emergency Medicine 8527085133 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A90435CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of California, a Medical Corporation Current Accepting new patients
American Current Care of California, a Medical Corporation CurrentSince Jan 12, 2025 Accepting new patients

Locations

2555 S East Ave
Fresno, CA 93706
Phone (559) 499-2400

2 Connecticut St
San Francisco, CA 94107
Phone (415) 621-5055

1221 N Dutton Ave
Santa Rosa, CA 95401
Phone (707) 543-8360

3 S Linden Ave
South San Francisco, CA 94080
Phone (650) 238-1500

21081 S Western Ave
Ste 150
Torrance, CA 90501
Phone (310) 782-3333

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466726400000",
    "number": "1346276813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2200",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923730722",
            "telephone_number": "909-793-3311",
            "fax_number": "909-796-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 BOULDER AVE",
            "city": "HIGHLAND",
            "state": "CA",
            "postal_code": "923463348",
            "telephone_number": "909-862-1191",
            "fax_number": "909-796-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRESCH",
        "first_name": "KEITH",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2016-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A90435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A904350",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland, CA

Sources for this page

Verify at the official NPI Registry.