CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG NPI 1144387614

NPI Information

NPI: 1144387614
Provider Name: CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG

Former Legal Business Name: CHILDREN'S ASSOCIATED MEDICAL GROUP

Classification: Surgery - 2086S0120X
Entity Type: Organization

Specialization: Pediatric Surgery

Address:
8010 FROST ST
SUITE 414
SAN DIEGO, CA
ZIP 92123
Phone: (858) 966-7711
Get Directions

CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG is a pediatric surgery surgery in San Diego, CA. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG NPI is 1144387614. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Children's Associated Medical Group.

The provider's business location address is:

8010 FROST ST
SUITE 414
SAN DIEGO, CA
ZIP 92123-778
Phone: (858) 966-7711

The provider's authorized official is Herbert C. Kimmons .
The authorized official title is President and has the following contact phone number (858) 966-8567.

The enumeration date for this NPI number is 1/3/2007 and was last updated on 4/22/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery				No
2	2086S0120X	Surgery	Pediatric Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W13774	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA	MEDICARE GROUP PROV#
2	GR0083550	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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