Wilshiremed Center Inc

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

C42850 Issued in CA

Legal business name

WILSHIREMED CENTER INC

Practice address

2131 Elks Dr
Ste 200
San Bernardino, CA 92404-5544

Phone

(909) 801-7374

Fax

(909) 495-1647

NPI assigned

Jan 7, 2010

Organization subpart

No

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

Authorized official

Name

Gerard J O'Dowd, M.D.

Title

President

Phone

90981027374

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262822400000",
    "number": "1659601920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3881 W 6TH ST",
            "address_2": "STE 127",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900203937",
            "telephone_number": "909-801-7374",
            "fax_number": "909-495-1647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 ELKS DR",
            "address_2": "STE 200",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924045544",
            "telephone_number": "909-801-7374",
            "fax_number": "909-495-1647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSHIREMED CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-07",
        "last_updated": "2010-01-07",
        "status": "A",
        "authorized_official_last_name": "O'DOWD",
        "authorized_official_first_name": "GERARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "90981027374",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "C42850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anatomic Pathology & Clinical Pathology Physician in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.