Active NPI
First Step Optimal Health Corporation
- Internal Medicine Physician
- Victorville, CA
National Provider Identifier
1609383363
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A552070
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 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 DirectoryLocations
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.
-
- Infectious Disease Physician
- Victorville, CA
- NPI 1306046123
Single Specialty
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.