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LAND PARK PEDIATRIC MEDICAL GROUP NPI 1487018990


NPI Information

NPI: 1487018990
Provider Name: LAND PARK PEDIATRIC MEDICAL GROUP
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D0616055

Address:
4617 FREEPORT BLVD STE B
SACRAMENTO, CA
ZIP 95822
Phone: (916) 422-7273
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LAND PARK PEDIATRIC MEDICAL GROUP is a pediatrics in Sacramento, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. LAND PARK PEDIATRIC MEDICAL GROUP NPI is 1487018990. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4617 FREEPORT BLVD STE B
SACRAMENTO, CA
ZIP 95822-015
Phone: (916) 422-7273
Fax: (916) 422-2127

The provider's authorized official is Ravinder Singh Khaira .
The authorized official title is Physician/owner and has the following contact phone number (916) 422-7273.

The CLIA number assigned to this NPI record is 05D0616055 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/11/2016 and was last updated on 4/11/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsA56390CALIFORNIAYes

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: 4/28/2024

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