Active NPI
Clyde Wesp Jr., M.D.
- Pediatrics Physician
- Ladera Ranch, CA
National Provider Identifier
1679679336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- G45946
- Practice address
- 800 Corporate Dr
Suite 280
Ladera Ranch, CA 92694-1152 - Phone
- (949) 388-1798
- NPI assigned
- Sep 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | G45946 | CA | Primary |
Addresses
Primary practice location
800 Corporate Dr
Suite 280
Ladera Ranch, CA 92694-1152
Mailing address
23321 El Toro Rd
Suites F&G
Lake Forest, CA 92630-4825
Phone (949) 770-0513
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G45946 | CA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679679336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23321 EL TORO RD",
"address_2": "SUITES F&G",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926304825",
"telephone_number": "949-770-0513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 CORPORATE DR",
"address_2": "SUITE 280",
"city": "LADERA RANCH",
"state": "CA",
"postal_code": "926941152",
"telephone_number": "949-388-1798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESP",
"first_name": "CLYDE",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G45946",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ladera Ranch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.