John Michael Waite, Physician Assistant, Inc.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

56135 Issued in CA

Legal business name

JOHN MICHAEL WAITE, PHYSICIAN ASSISTANT, INC.

Practice address

3325 17TH St
Santa Monica, CA 90405-5832

Phone

(310) 968-3123

NPI assigned

Aug 6, 2014

Last updated

Aug 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Michael Waite, PA-CNPI 1265844708

Title

President

Phone

(310) 968-3123

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John M. Waite, PA-C

  • Physician Assistant
  • Kapolei, HI
  • NPI 1265844708
  NPD (past) Authorized official

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407283200000",
    "number": "1992114730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3325 17TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3325 17TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055832",
            "telephone_number": "310-968-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN MICHAEL WAITE, PHYSICIAN ASSISTANT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A",
        "authorized_official_last_name": "WAITE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-968-3123",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "56135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; 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.