Active NPI
Charles W Mayfield Jr., PA-C
- Physician Assistant
- Hemet, CA
National Provider Identifier
1932253242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA16292
- Practice address
- 1225 E Latham Ave Ste B
Hemet, CA 92543-4423 - Phone
- (951) 929-2800
- Fax
- (951) 929-2303
- NPI assigned
- Jan 23, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA16292 | MN | Primary |
Addresses
Primary practice location
1225 E Latham Ave Ste B
Hemet, CA 92543-4423
Mailing address
1225 E Latham Ave Ste B
Hemet, CA 92543-4423
Phone (951) 929-2800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA137652 | Medicaid | CA |
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 |
|---|---|---|---|
| PA16292 | MN | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1932253242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1225 E LATHAM AVE STE B",
"city": "HEMET",
"state": "CA",
"postal_code": "925434423",
"telephone_number": "951-929-2800",
"fax_number": "951-929-2303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 E LATHAM AVE STE B",
"city": "HEMET",
"state": "CA",
"postal_code": "925434423",
"telephone_number": "951-929-2800",
"fax_number": "951-929-2303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAYFIELD",
"first_name": "CHARLES",
"middle_name": "W",
"name_suffix": "Jr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "PA16292",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "CA137652",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.