EATON PEDIATRICS & MEDICAL CORP. NPI 1336249713

NPI Information

  • NPI: 1336249713
  • Provider Name: EATON PEDIATRICS & MEDICAL CORP.
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 05D1019486
  • Address: 518 W EATON AVE
    TRACY, CA
    ZIP 95376
  • Phone: (209) 833-2228

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NPI Details

EATON PEDIATRICS & MEDICAL CORP. is a pediatrics in Tracy, 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. EATON PEDIATRICS & MEDICAL CORP. NPI is 1336249713. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

518 W EATON AVE
TRACY, CA
ZIP 95376-422
Phone: (209) 833-2228

The provider's authorized official is Manuel R De La Cruz .
The authorized official title is President and has the following contact phone number (209) 833-2228.

The CLIA number assigned to this NPI record is 05D1019486 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/25/2006 and was last updated on 8/22/2020.

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
1208000000XPediatricsA74123CALIFORNIANo
2208000000XPediatricsA50064CALIFORNIAYes

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
1ZZZ01387ZOTHERCALIFORNIABLUE SHIELD GROUP ID#

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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