NPIMap

Organization Active NPI

James I. Wallstrom, M.D., Inc.

  • Internal Medicine Physician
  • Pasadena, CA
National Provider Identifier
1881989085
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G74317 Issued in CA
Legal business name
JAMES I. WALLSTROM, M.D., INC.
Practice address
50 Bellefontaine St Ste 205
Pasadena, CA 91105-3132
Phone
(626) 792-4115
Fax
(626) 792-3103
NPI assigned
Jun 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Authorized official

Name
James I Wallstrom, M.D.
Title
President
Phone
(626) 792-4115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X G74317 CA Primary

Addresses

Primary practice location

50 Bellefontaine St Ste 205
Pasadena, CA 91105-3132

Mailing address

50 Bellefontaine St Ste 205
Pasadena, CA 91105-3132
Phone (626) 792-4115

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1881989085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 BELLEFONTAINE ST STE 205",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053132",
            "telephone_number": "626-792-4115",
            "fax_number": "626-792-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BELLEFONTAINE ST STE 205",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911053132",
            "telephone_number": "626-792-4115",
            "fax_number": "626-792-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES I. WALLSTROM, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-15",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "WALLSTROM",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-792-4115",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G74317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; 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.