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PACIFIC PEDIATRICS MED GRP INC NPI 1366539884


NPI Information

NPI: 1366539884
Provider Name: PACIFIC PEDIATRICS MED GRP INC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D0594731

Address:
45 CASTRO STREET
SUITE 232
SAN FRANCISCO, CA
ZIP 94114
Phone: (415) 565-6810
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PACIFIC PEDIATRICS MED GRP INC is a pediatrics in San Francisco, 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. PACIFIC PEDIATRICS MED GRP INC NPI is 1366539884. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

45 CASTRO STREET
SUITE 232
SAN FRANCISCO, CA
ZIP 94114
Phone: (415) 565-6810
Fax: (415) 565-6844

The provider's authorized official is William Bernard Solomon .
The authorized official title is Treasurer and has the following contact phone number (415) 565-6810.

The CLIA number assigned to this NPI record is 05D0594731 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/6/2006 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatrics207731CALIFORNIAYes

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
1GR0026450MEDICAIDCALIFORNIA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.