Summit Medical Group

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

SUMMIT MEDICAL GROUP

Practice address

27702 Crown Valley Pkwy
Suite D4-113
Ladera Ranch, CA 92694-0608

Phone

(949) 529-2330

Fax

(866) 800-5276

NPI assigned

Nov 14, 2014

Organization subpart

No

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

Authorized official

Name

Ghalib Wahidi, MD

Title

MD

Phone

(949) 529-2330

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420502400000",
    "number": "1831595024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27702 CROWN VALLEY PKWY",
            "address_2": "SUITE D4-113",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926940608",
            "telephone_number": "949-529-2330",
            "fax_number": "866-800-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27702 CROWN VALLEY PKWY",
            "address_2": "SUITE D4-113",
            "city": "LADERA RANCH",
            "state": "CA",
            "postal_code": "926940608",
            "telephone_number": "949-529-2330",
            "fax_number": "866-800-5276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-14",
        "last_updated": "2015-01-06",
        "status": "A",
        "authorized_official_last_name": "WAHIDI",
        "authorized_official_first_name": "GHALIB",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "949-529-2330",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Ladera Ranch, CA
• Providers in Ladera Ranch, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.