SHAFTER PEDIATRICS NPI 1821763590

NPI Information

NPI: 1821763590
Provider Name: SHAFTER PEDIATRICS
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Doing Business As: ELMO PEDIATRICS & FAMILY WALK-IN CLINIC
CLIA Number: 05D2289448
Address: 501 MUNZER ST
SUITE C
SHAFTER, CA
ZIP 93263
Phone: (661) 630-5274

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NPI Details

SHAFTER PEDIATRICS is a clinic center in Shafter, CA. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). SHAFTER PEDIATRICS NPI is 1821763590. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Elmo Pediatrics & Family Walk-in Clinic.

The provider's business location address is:

501 MUNZER ST
SUITE C
SHAFTER, CA
ZIP 93263-042
Phone: (661) 630-5274
Fax: (661) 630-5290

The provider's authorized official is Ayodeji Adetayo Ayeni .
The authorized official title is Medical Director and has the following contact phone number (661) 364-5244.

The CLIA number assigned to this NPI record is 05D2289448 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/13/2021 and was last updated on 12/29/2023.

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
1	208000000X	Pediatrics				No
2	261Q00000X	Clinic/Center				Yes

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
1	552863	OTHER	CALIFORNIA	MEDICAL BOARD OF CALIFORNIA

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: 11/21/2025

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