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Contact Information

PEDIATRIC PARTNERS MEDICAL PROFESSIONAL CORPORATION
1111 N CHINA LAKE BLVD
SUITE 120
RIDGECREST, CA93555-3131
 Phone: 760-446-7337
 Fax: 760-446-7338
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Adolescent Medicine

2080A0000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for PEDIATRIC PARTNERS MEDICAL PROFESSIONAL CORPORATION

NPI # 1356656664
LBN Legal business name PEDIATRIC PARTNERS MEDICAL PROFESSIONAL CORPORATION
Authorized official CHERYL FUCHIGAMI-BOST, RN - (CHIEF OPERATIONS OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/11/2010
Last updated 08/11/2010 - About 16 years ago
Identifiers
CA License # 0900009973
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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