CASSIDY MEDICAL GROUP -PEDS NPI 1235206293

NPI Information

  • NPI: 1235206293
  • Provider Name: CASSIDY MEDICAL GROUP -PEDS
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Address: 2067 W VISTA WAY STE 280
    VISTA, CA
    ZIP 92083
  • Phone: (760) 941-3630

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NPI Details

CASSIDY MEDICAL GROUP -PEDS is a pediatrics in Vista, 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. CASSIDY MEDICAL GROUP -PEDS NPI is 1235206293. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2067 W VISTA WAY STE 280
VISTA, CA
ZIP 92083-034
Phone: (760) 941-3630
Fax: (760) 941-1214

The provider's authorized official is Judith M Krueger .
The authorized official title is Executive Director and has the following contact phone number (760) 630-5487.

The enumeration date for this NPI number is 11/28/2006 and was last updated on 10/13/2010.

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
1208000000XPediatricsYes

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
1W41833AOTHERMEDICARE PTAN

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: 3/30/2025

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