1932065448 NPI number — COMPASSUS OF CALIFORNIA PHYSICIANS GROUP, P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932065448 NPI number — COMPASSUS OF CALIFORNIA PHYSICIANS GROUP, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMPASSUS OF CALIFORNIA PHYSICIANS GROUP, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932065448
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/29/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26661 BUCKINGHAM DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN CAPISTRANO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92675-1421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
714-402-9942
Provider Business Mailing Address Fax Number:
949-606-8228

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
414 S JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94559-4515
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
707-531-6190
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/29/2025

Additional Information

Authorized Official

Authorized Official Last Name:
GLASGOW
Authorized Official First Name:
GORDON
Authorized Official Middle Name:
ARTHUR
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
714-402-9942

Provider Taxonomy Codes

  • Taxonomy code: 207RH0002X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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