Aspen Medical Clinic Inc.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

A79778 Issued in CA

Legal business name

ASPEN MEDICAL CLINIC INC.

Practice address

12368 Winesap Rd
Apple Valley, CA 92308-5143

Phone

(760) 240-5044

Fax

(760) 240-5119

NPI assigned

Jul 26, 2006

Organization subpart

No

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

Authorized official

Name

Wahid Midou, M.D.

Title

Owner

Phone

(760) 240-5044

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Somasekhara Reddy Kaipu, M.D.,

  • Hospitalist Physician
  • Zephyrhills, FL
  • NPI 1710153481

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211932800000",
    "number": "1467475806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12368 WINESAP RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923085143",
            "telephone_number": "760-240-5044",
            "fax_number": "760-240-5119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12368 WINESAP RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923085143",
            "telephone_number": "760-240-5044",
            "fax_number": "760-240-5119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN MEDICAL CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2008-05-28",
        "status": "A",
        "authorized_official_last_name": "MIDOU",
        "authorized_official_first_name": "WAHID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-240-5044",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CA",
            "license": "A79778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2008; 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.