Active NPI
Executive Medical & Surgical Assoc. Inc.
- Specialist
- Colton, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- A72267
- Legal business name
- EXECUTIVE MEDICAL & SURGICAL ASSOC. INC.
- Practice address
- 900 E Washington St Ste 200
Colton, CA 92324-4192 - Phone
- (909) 824-2422
- Fax
- (909) 824-8234
- NPI assigned
- Aug 10, 2006
- Last updated
- Aug 22, 2020
- 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
- Darren L Bergey, M.D.
- Title
- President
- Phone
- (909) 824-2422
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | A72267 | CA | Primary |
Addresses
Primary practice location
900 E Washington St Ste 200
Colton, CA 92324-4192
Mailing address
1040 S. Mt. Vernon Ave.
#G350
Colton, CA 92324
Phone (909) 824-2422
National Provider Directory
National Provider Directory- Tax ID family
- Bergey Spine Institute
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Bergey Spine Institute
- Specialist
- Colton, CA
- NPI 1144775016
Locations
1040 S Mount Vernon Ave
#G350
Colton, CA 92324
Phone (909) 824-2422
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Specialist
- Colton, CA
- NPI 1861464711
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155168000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1609887322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 S. MT. VERNON AVE.",
"address_2": "#G350",
"city": "COLTON",
"state": "CA",
"postal_code": "92324",
"telephone_number": "909-824-2422",
"fax_number": "909-824-8234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 E WASHINGTON ST STE 200",
"city": "COLTON",
"state": "CA",
"postal_code": "923244192",
"telephone_number": "909-824-2422",
"fax_number": "909-824-8234"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EXECUTIVE MEDICAL & SURGICAL ASSOC. INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-08-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "BERGEY",
"authorized_official_first_name": "DARREN",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "909-824-2422",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "A72267",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colton, CA
- Rosanne Inez Evans
- Sara Elizabeth Cherry Evans, M.S.
- Matthew Ewell
- Kathleen Ewing
- Excelcare Hospice Inc
- Executive Medical & Surgical Associates Inc. (Bergey Spine Institute)
- Executive Medical & Surgical Associates Inc.
- Julie O Eze
- Czarina Irish Facer, M.S., CCC-SLP
- Faculty Medical Group of Llusm (Faculty Medical Group of Llusm-Radiology)
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.