Corwin Urgent Care Center

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A54482 Issued in CA

Legal business name

CORWIN URGENT CARE CENTER

Practice address

16070 Tuscola Road
#101
Apple Valley, CA 92307

Phone

(760) 242-4000

Fax

(760) 242-5250

NPI assigned

Mar 16, 2007

Last updated

Oct 9, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dawit Mamo, M.D.NPI 1346251568

Title

Ceo

Phone

(760) 946-2957

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 2

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.

• Dawit Mamo, M.D.

  • Internal Medicine Physician
  • Apple Valley, CA
  • NPI 1346251568
  Medicare reassignment NPD Authorized official
• Clement-John Ajayi

  • Behavior Technician
  • Apple Valley, CA
  • NPI 1285290205
  NPD (past)

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223510400000",
    "number": "1386768448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3800",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923070074",
            "telephone_number": "760-242-4000",
            "fax_number": "760-242-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16070 TUSCOLA ROAD",
            "address_2": "#101",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "92307",
            "telephone_number": "760-242-4000",
            "fax_number": "760-242-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORWIN URGENT CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-10-09",
        "status": "A",
        "authorized_official_last_name": "MAMO",
        "authorized_official_first_name": "DAWIT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-946-2957",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A54482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0054490",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Juan Corral Jr.
• Cristina Angela Cortez
• Miranda Renee Cortez, MA, BCBA, LBA
• Corwin Kids Healthcare Inc (Corwin Congregate Living)
• Corwin Medical Group Inc Ipa
• Tracy Catherine Cosmos
• Sheryl Anne Costa, AOD
• Amy Couch
• Counting Stars Management LLC.
• Country Club Care

• Internal Medicine Physician in Apple Valley, CA
• Providers in Apple Valley, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.