Organization Active NPI

First Step Optimal Health Corporation

  • Internal Medicine Physician
  • Victorville, CA
National Provider Identifier
1609383363
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A552070 Issued in CA
Legal business name
FIRST STEP OPTIMAL HEALTH CORPORATION
Practice address
17290 Jasmine St Ste 101
Victorville, CA 92395-8300
Phone
(760) 951-2400
Fax
(951) 840-2088
NPI assigned
Jan 3, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Authorized official

Name
Charles Waits
Title
Office MGR
Phone
(909) 322-3124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X A552070 CA Primary

Addresses

Primary practice location

17290 Jasmine St Ste 101
Victorville, CA 92395-8300

Mailing address

17290 Jasmine St Ste 101
Victorville, CA 92395-8300
Phone (760) 951-2400

National Provider Directory

National Provider Directory

Locations

17290 Jasmine St
Ste 101
Victorville, CA 92395
Phone (760) 951-2400

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514937600000",
    "number": "1609383363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17290 JASMINE ST STE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958300",
            "telephone_number": "760-951-2400",
            "fax_number": "951-840-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17290 JASMINE ST STE 101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958300",
            "telephone_number": "760-951-2400",
            "fax_number": "951-840-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST STEP OPTIMAL HEALTH CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A",
        "authorized_official_last_name": "WAITS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "909-322-3124"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A552070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.