NPIMap

Organization Active NPI

Fred M Watkins MD PC

  • Family Medicine Physician
  • Corona, CA
National Provider Identifier
1992141469
Registry record updated Dec 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A117467 Issued in CA
Legal business name
FRED M WATKINS MD PC
Practice address
1810 Fullerton Ave
Suite #104
Corona, CA 92881-3103
Phone
(951) 200-6919
Fax
(951) 200-6919
NPI assigned
May 10, 2013
Last updated
Dec 11, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2013

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

Authorized official

Name
Fred Watkins, MDNPI 1417244591
Title
President
Phone
(310) 792-3914

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A117467 CA Primary

Addresses

Primary practice location

1810 Fullerton Ave
Suite #104
Corona, CA 92881-3103

Mailing address

PO Box 3098
Torrance, CA 90510-3098
Phone (310) 792-3914

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1368144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386720000000",
    "number": "1992141469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3098",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103098",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 FULLERTON AVE",
            "address_2": "SUITE #104",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813103",
            "telephone_number": "951-200-6919",
            "fax_number": "951-200-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED M WATKINS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-10",
        "last_updated": "2013-12-11",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "FRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-792-3914",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A117467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; 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.