Carl Wolnisty MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G5804 Issued in CA

Legal business name

CARL WOLNISTY MD INC

Practice address

3838 Sherman Dr
Suite 7
Riverside, CA 92503-4098

Phone

(951) 688-5122

Fax

(951) 688-8145

NPI assigned

Mar 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Carl Wolnisty, M.D

Title

President

Phone

(951) 688-5122

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1982875704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR",
            "address_2": "SUITE 7",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034098",
            "telephone_number": "951-688-5122",
            "fax_number": "951-688-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 SHERMAN DR",
            "address_2": "SUITE 7",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034098",
            "telephone_number": "951-688-5122",
            "fax_number": "951-688-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL WOLNISTY MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "WOLNISTY",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-688-5122",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G5804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CR239A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Riverside, CA
• Providers in Riverside, 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 Oct 5, 2011; 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.