Active NPI
John Robert Western, PA
- Medical Physician Assistant
- San Diego, CA
National Provider Identifier
1679679682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA11423
- Practice address
- 4405 Vandever Ave
3Rd Floor, Kaiser Permanente
San Diego, CA 92120-3315 - Phone
- (619) 516-7366
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA11423 | CA | Primary |
Addresses
Primary practice location
4405 Vandever Ave
3Rd Floor, Kaiser Permanente
San Diego, CA 92120-3315
Mailing address
4405 Vandever Ave
3Rd Floor, Kaiser Permanente
San Diego, CA 92120-3315
Phone (619) 516-7366
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2344 | AK | MD | Internal Medicine 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": "1679679682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4405 VANDEVER AVE",
"address_2": "3RD FLOOR, KAISER PERMANENTE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921203315",
"telephone_number": "619-516-7366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4405 VANDEVER AVE",
"address_2": "3RD FLOOR, KAISER PERMANENTE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921203315",
"telephone_number": "619-516-7366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WESTERN",
"first_name": "JOHN",
"middle_name": "ROBERT",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CA",
"license": "PA11423",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, 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.