Active NPI
Charles S. Taft, M.D.
- Internal Medicine Physician
- Temecula, CA
National Provider Identifier
1366409617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- G55046
- Practice address
- 28780 Single Oak Drive
Suite 160
Temecula, CA 92590-5528 - Phone
- (951) 676-4193
- Fax
- (951) 719-1469
- NPI assigned
- Apr 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | G55046 | CA | Primary |
Addresses
Primary practice location
28780 Single Oak Drive
Suite 160
Temecula, CA 92590-5528
Mailing address
28780 Single Oak Drive
Suite 160
Temecula, CA 92590-5528
Phone (951) 676-4193
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ49298Z | Other | CA | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55046 | CA | MD | General Practice Dentistry |
| G55046 | CA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146182400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297382400000",
"number": "1366409617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28780 SINGLE OAK DRIVE",
"address_2": "SUITE 160",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925905528",
"telephone_number": "951-676-4193",
"fax_number": "951-719-1469"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28780 SINGLE OAK DRIVE",
"address_2": "SUITE 160",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925905528",
"telephone_number": "951-676-4193",
"fax_number": "951-719-1469"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAFT",
"first_name": "CHARLES",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-28",
"last_updated": "2011-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "G55046",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "ZZZ49298Z",
"state": "CA"
}
],
"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 Feb 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.