Organization Active NPI

William P Baugh MD Inc

  • Dermatology Physician
  • Fullerton, CA
National Provider Identifier
1619075116
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
G77769 Issued in CA
Legal business name
WILLIAM P BAUGH MD INC
Practice address
333 W Bastanchury Rd
Suite 110
Fullerton, CA 92835-3420
Phone
(714) 879-4312
Fax
(714) 879-2154
NPI assigned
Sep 20, 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
Dr. William P Baugh, MDNPI 1891725602
Title
President
Phone
(714) 879-4312

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)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X G77769 CA Primary

Addresses

Primary practice location

333 W Bastanchury Rd
Suite 110
Fullerton, CA 92835-3420

Mailing address

333 W Bastanchury Rd
Suite 110
Fullerton, CA 92835-3420
Phone (714) 879-4312

Other identifiers 1

IdentifierTypeStateIssuer
00G777690MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121012000383 CA Part B Supplier - Clinic/Group Practice 2668621392 Receives reassigned benefits from 3 practitioners
Practice locations: Fullerton, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619075116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W BASTANCHURY RD",
            "address_2": "SUITE 110",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353420",
            "telephone_number": "714-879-4312",
            "fax_number": "714-879-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W BASTANCHURY RD",
            "address_2": "SUITE 110",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353420",
            "telephone_number": "714-879-4312",
            "fax_number": "714-879-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM P BAUGH MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAUGH",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-879-4312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G77769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G777690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fullerton, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.