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CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF CARD NPI 1568529147


NPI Information

NPI: 1568529147
Provider Name: CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF CARD

Former Legal Business Name: CHILDREN'S ASSOCIATED MEDICAL GROUP

Classification: Pediatrics - 2080P0202X
Entity Type: Organization

Specialization: Pediatric Cardiology

Address:
8001 FROST ST
ENTRANCE 9
SAN DIEGO, CA
ZIP 92123
Phone: (858) 966-5855
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CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF CARD is a pediatric cardiology pediatrics in San Diego, CA. The provider is a pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF CARD NPI is 1568529147. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Children's Associated Medical Group.

The provider's business location address is:

8001 FROST ST
ENTRANCE 9
SAN DIEGO, CA
ZIP 92123-746
Phone: (858) 966-5855

The provider's authorized official is Herbert C. Kimmons .
The authorized official title is President and has the following contact phone number (858) 966-8567.

The enumeration date for this NPI number is 1/2/2007 and was last updated on 4/22/2008.


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
1208000000XPediatricsNo
22080P0202XPediatricsPediatric CardiologyYes

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
1W13774MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAMEDICARE GROUP PROV#
2GR006886BMEDICAIDCALIFORNIA

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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