Organization Active NPI

Dwight L. Roberson, M.D. Inc.

  • Plastic Surgery Physician
  • Paramount, CA
National Provider Identifier
1508828831
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G32654 Issued in CA
Legal business name
DWIGHT L. ROBERSON, M.D. INC.
Practice address
16444 Paramount Blvd
Suite #208
Paramount, CA 90723-5422
Phone
(562) 790-8545
Fax
(562) 790-2433
NPI assigned
Apr 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Esther Louise Roberson
Title
Office Manager
Phone
(562) 790-8545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X G32654 CA Primary

Addresses

Primary practice location

16444 Paramount Blvd
Suite #208
Paramount, CA 90723-5422

Mailing address

16444 Paramount Blvd
Suite #208
Paramount, CA 90723-5422
Phone (562) 790-8545

Other identifiers 1

IdentifierTypeStateIssuer
0G3265400MedicaidCA

National Provider Directory

National Provider Directory

Locations

16444 Paramount Blvd
Ste 208
Paramount, CA 90723
Phone (562) 790-8545

4315 Houma Blvd
Ste 305
Metairie, LA 70006
Phone (504) 455-4622

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508828831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16444 PARAMOUNT BLVD",
            "address_2": "SUITE #208",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235422",
            "telephone_number": "562-790-8545",
            "fax_number": "562-790-2433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16444 PARAMOUNT BLVD",
            "address_2": "SUITE #208",
            "city": "PARAMOUNT",
            "state": "CA",
            "postal_code": "907235422",
            "telephone_number": "562-790-8545",
            "fax_number": "562-790-2433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DWIGHT L. ROBERSON, M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "ESTHER",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "562-790-8545",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G32654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0G3265400",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paramount, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.