Stewart Elvis Rendon, M.D., Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A78664 Issued in CA

Legal business name

STEWART ELVIS RENDON, M.D., INC.

Practice address

11100 Warner Ave
Suite 258
Fountain Valley, CA 92708-7506

Phone

(714) 549-5990

Fax

(714) 845-0041

NPI assigned

May 28, 2015

Organization subpart

No

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

Authorized official

Name

Stewart Elvis Rendon, M.D.

Title

Ceo

Phone

(646) 554-4491

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1432771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439164800000",
    "number": "1376922021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 258",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-549-5990",
            "fax_number": "714-845-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 258",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-549-5990",
            "fax_number": "714-845-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEWART ELVIS RENDON, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-28",
        "last_updated": "2015-08-10",
        "status": "A",
        "authorized_official_last_name": "RENDON",
        "authorized_official_first_name": "STEWART",
        "authorized_official_middle_name": "ELVIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "646-554-4491",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A78664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.