WILLIAM C TA MDSPECTRUM MEDICAL & WELLNESS CENTER (NPI# 1437404142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437404142 |
| Entity Type | Organization |
| Organization Name | WILLIAM C TA MDSPECTRUM MEDICAL & WELLNESS CENTER |
| Other Organization Name | SPECTRUM MEDICAL & WELLNESS CENTER |
| Practice Address |
15095 Amargosa Rd Bldg 2, Ste 280 Victorville CA 92394-1879 |
| Practice Telephone | 7609529100 |
| Practice Fax Number | 7609529228 |
| Mailing Telephone | 7609529100 |
| Mailing Fax Number | 7609529228 |
| Enumeration Date | 2012-07-18 |
| Last Update Date | 2012-07-18 |
| Authorized Official Name | DR. ONYENKWERE O OKWANDU (OFFICE MANAGER) |
| Authorized Official Telephone | 7602469555 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | A118947 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SPECTRUM MEDICAL & WELLNESS CENTER | Doing Business As Name - Organization |
| Street Address |
15095 AMARGOSA RD BLDG 2, STE 280 |
| City | VICTORVILLE |
| State | CA |
| Zip Code | 92394-1879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457332884 | Mojave Valley Physical Therapy | Physical Therapist | 15095 Amargosa Rd, Suite 104, Victorville, CA 92394-1879 | 2005-11-11 |
| 1013518547 | Syville Talbird | Community Health Worker | 15095 Amargosa Rd, Victorville, CA 92394-1879 | 2020-11-02 |
| 1780282400 | Haynnette Griselda Jimenez | Community Health Worker | 15095 Amargosa Rd, Victorville, CA 92394-1879 | 2020-10-14 |
| 1053919944 | Carmela Santos | Case Manager/Care Coordinator | 15095 Amargosa Rd, Victorville, CA 92394-1879 | 2020-10-13 |
| 1891393799 | Omoyinka Orekoya | Community Health Worker | 15095 Amargosa Rd, Victorville, CA 92394-1879 | 2020-10-13 |
| 1891312377 | Lilliana G Melgar | Community Health Worker | 15095 Amargosa Rd, Victorville, CA 92394-1879 | 2020-06-30 |
| 1205472438 | Elizabeth Difox | Case Manager/Care Coordinator | 15095 Amargosa Rd, Victorville, CA 92394-1879 | 2019-11-22 |
| 1639728694 | Maria L Perez | Case Manager/Care Coordinator | 15095 Amargosa Rd, Victorville, CA 92394-1879 | 2019-09-11 |
| 1760946560 | Myesha Niyoka Alexander | Case Manager/Care Coordinator | 15095 Amargosa Rd, Victorville, CA 92394-1879 | 2019-01-25 |
| 1265922835 | Katherine Nicole Schilling | Marriage & Family Therapist | 15095 Amargosa Rd, Victorville, CA 92394-1879 | 2018-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164045803 | Desert Horizon Residential Care | Assisted Living Facility | 15952 Condor Rd, Victorville, CA 92394 | 2020-05-28 |
| 1467000943 | Tawanna Lasha Young | Counselor | 15095 Armargosa, Ste 208, Victorville, CA 92394 | 2019-08-28 |
| 1811543473 | Silvano Gonzalez | Transportation Broker | 13767 Hidden Mesa Ct, Victorville, CA 92394 | 2019-08-09 |
| 1215442793 | Yun Jung Choi | Pharmacist | 15318 Roy Rogers Dr., Victorville, CA 92394 | 2017-12-06 |
| 1770942914 | Monica Castro | Marriage & Family Therapist | 15095 Armargosa Rd, 208, Victorville, CA 92394 | 2016-02-16 |
| 1902289226 | Daesoon Leem | Family Medicine | 15095 Amargosa Rd, Bldg.1, #102, Victorville, CA 92394 | 2015-07-06 |
| 1093068322 | City Taxi | Taxi | 14871 Totem Pole St, Victorville, CA 92394 | 2012-10-24 |
| 1467701318 | Margarita Renee Ortega | Counselor | 16224 Tawney Ridge Lane, Victorville, CA 92394 | 2012-09-06 |
| 1326328584 | Pro Line Transportation LLC | Non-emergency Medical Transport (VAN) | 10604 Karen Dr, Victorville, CA 92394 | 2011-08-19 |
| 1164604906 | Maxim Healthcare Services, Inc. | Home Health | 15095 Amargosa Road, Suite 102, Victorville, CA 92394 | 2007-12-04 |
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| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
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| 1841679206 | Active Care Chiropractic, Inc. By Dr. Sara | Clinic/Center | 14156 Amargosa Rd Ste G, Victorville, CA 92392-2417 | 2015-05-19 |
| 1225376809 | Planned Parenthood of Orange and San Bernardino Counties | Clinic/Center | 15403 Park Ave E, Victorville, CA 92392-2482 | 2013-01-16 |
| 1164448593 | Cal Choice Family Practice Inc | Clinic/Center | 16519 Victor St, Suite 307, Victorville, CA 92395-3922 | 2006-07-15 |
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| 1902417678 | I-ma Acupuncture Inc | Clinic/Center | 2485 High School Ave Ste 123, Concord, CA 94520-1812 | 2020-08-14 |
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| City | VICTORVILLE |
| Zip Code | 92394 |
Please comment or provide details below to improve the information on WILLIAM C TA MDSPECTRUM MEDICAL & WELLNESS CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.