Individual provider Active NPI

Charles E Stewart, M.D.

  • Otolaryngology Physician
  • Loma Linda, CA
National Provider Identifier
1407888217
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G21259 Issued in CA
Practice address
11370 Anderson St
Suite 2100
Loma Linda, CA 92354-3450
Phone
(909) 558-2822
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X G21259 CA Primary

Addresses

Primary practice location

11370 Anderson St
Suite 2100
Loma Linda, CA 92354-3450

Mailing address

54701 File Number
Los Angeles, CA 90074-4701
Phone (909) 558-3111

Other identifiers 1

IdentifierTypeStateIssuer
00G212590MedicaidCA

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
I20041222000756 CA Practitioner - OtolaryngologyPractitioner - Other (Physician)Practitioner - General Surgery 5698733566 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G21259CAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Orohealth Corporation a Non Profit Healthcare System CurrentSince Apr 29, 2018 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Jan 1, 2005 Accepting new patients
Oroville Hospital PastSince Apr 29, 2018 Accepting new patients

Locations

11370 Anderson St
Ste 2100
Loma Linda, CA 92354
Phone (909) 558-2824

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

25455 Barton Rd
Ste 108A
Loma Linda, CA 92354
Phone (909) 558-1617

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

28078 Baxter Rd
Murrieta, CA 92563
Phone (951) 290-4000

2721 Olive Hwy
Ste 9
Oroville, CA 95966
Phone (530) 532-4400

2767 Olive Hwy
Oroville, CA 95966
Phone (916) 533-8500

2809 Olive Hwy
Oroville, CA 95966
Phone (530) 532-8654

2767 Olive Hwy
#260
Oroville, CA 95966
Phone (530) 532-8544

2780 Oro Dam Blvd E
Ste 2
Oroville, CA 95966
Phone (530) 533-7727

2809 Olive Hwy
Ste 210
Oroville, CA 95966
Phone (530) 532-8010

900 Oro Dam Blvd E
Oroville, CA 95965
Phone (530) 534-9183

2809 Olive Hwy
Ste 150
Oroville, CA 95966
Phone (530) 532-8180

3762 Tibbetts St
Riverside, CA 92506
Phone (951) 686-2224

Interoperability endpoints

  • Direct secure messaging: cstewart11423@direct.llu.edu

Organizations & group practices 4

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": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1407888217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54701 FILE NUMBER",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900744701",
            "telephone_number": "909-558-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11370 ANDERSON ST",
            "address_2": "SUITE 2100",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923543450",
            "telephone_number": "909-558-2822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CHARLES",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "G21259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G212590",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.