Otto Stallworth, M.D.,Inc.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

C33769 Issued in CA

Legal business name

OTTO STALLWORTH, M.D.,INC.

Practice address

4500 W 116TH St
Hawthorne, CA 90250-2209

Phone

(800) 883-7243

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Otto Stallworth, M.D.NPI 1639133747

Title

President

Phone

(800) 883-7243

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Otto Evans Stallworth, M.D.

  • Anesthesiology Physician
  • Hawthorne, CA
  • NPI 1639133747
  NPD (past) Authorized official

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198886400000",
    "number": "1972673499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1012",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 W 116TH ST",
            "city": "HAWTHORNE",
            "state": "CA",
            "postal_code": "902502209",
            "telephone_number": "800-883-7243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTO STALLWORTH, M.D.,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-12-29",
        "status": "A",
        "authorized_official_last_name": "STALLWORTH",
        "authorized_official_first_name": "OTTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-883-7243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "C33769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C337690",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anthony Ortega, DDS
• Orthodontics Only
• Orthoodntics Only
• Ana Rosa Ortiz, D.D.S.
• Cindy Paola Ortiz, COTA/L
• Caitlin Outland, PA-C
• P K Sehdeva MD a Professional Corporation
• Pacific Coast Healthcare Services LLC
• Ray Ralph Padilla, DDS
• Daniel Pae

• Anesthesiology Physician in Hawthorne, CA
• Providers in Hawthorne, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.

Verify at the official NPI Registry.