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SAN BRUNO PEDIATRICS INC NPI 1538241252


NPI Information

NPI: 1538241252
Provider Name: SAN BRUNO PEDIATRICS INC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D1022247

Address:
1001 SNEATH LANE
SUITE 104
SAN BRUNO, CA
ZIP 94066
Phone: (650) 873-4545
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SAN BRUNO PEDIATRICS INC is a pediatrics in San Bruno, 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. SAN BRUNO PEDIATRICS INC NPI is 1538241252. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1001 SNEATH LANE
SUITE 104
SAN BRUNO, CA
ZIP 94066
Phone: (650) 873-4545
Fax: (650) 873-4544

The provider's authorized official is Maria Vanessa Abunto .
The authorized official title is President and has the following contact phone number (650) 873-4545.

The CLIA number assigned to this NPI record is 05D1022247 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/20/2006 and was last updated on 5/2/2018.


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
1208000000XPediatricsA60694CALIFORNIAYes
2208000000XPediatricsA80451CALIFORNIANo

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11538241252MEDICAIDCALIFORNIA

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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