Organization Active NPI

Charles Taylor Medical Corp

  • Diagnostic Radiology Physician
  • Rancho Cucamonga, CA
National Provider Identifier
1851422281
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
CHARLES TAYLOR MEDICAL CORP
Practice address
10722 Arrow Rte Ste 512
Rancho Cucamonga, CA 91730-4840
Phone
(818) 913-9940
Fax
(562) 349-0457
NPI assigned
Mar 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Authorized official

Name
Dr. Charles TaylorNPI 1578594289
Title
President
Phone
(760) 217-0492

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
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

10722 Arrow Rte Ste 512
Rancho Cucamonga, CA 91730-4840

Mailing address

65 Pine Ave # 246
Long Beach, CA 90802-4718
Phone (760) 217-0492

Other practice location 1

4000 Empire Dr
Ste 100
Bakersfield, CA 93309-0400
Phone (760) 946-5177

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040929000896 CA Part B Supplier - Clinic/Group Practice 0244209963 Receives reassigned benefits from 1 practitioner
Practice locations: Rancho Cucamonga, CA

National Provider Directory

National Provider Directory
Tax ID family
Charles Taylor Medical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1851422281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 PINE AVE # 246",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908024718",
            "telephone_number": "760-217-0492",
            "fax_number": "562-349-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10722 ARROW RTE STE 512",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304840",
            "telephone_number": "818-913-9940",
            "fax_number": "562-349-0457"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Empire Dr",
            "address_2": "STE 100",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933090400",
            "country_code": "US",
            "telephone_number": "760-946-5177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHARLES TAYLOR MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-217-0492",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.