National Provider Identifier Database

KIDS CRITICAL CARE MEDICAL GROUP INC
Children


Contact Information

KIDS CRITICAL CARE MEDICAL GROUP INC
1111 WEST LA PALMA AVE
ANAHEIM MEMORIAL MEDICAL CENTER
ANAHEIM, CA92801-2881
Phone: 714-999-5144
Fax: 714-999-5143
Website:
Specialty Taxonomy Code
* Children 282NC2000X

* Indicates primary specialty

NPI Profile & details for KIDS CRITICAL CARE MEDICAL GROUP INC

NPI Number 1528144763
Legal business name
LBN
KIDS CRITICAL CARE MEDICAL GROUP INC
Authorized official SANDY SHAW - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 10/31/2006
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: 047879
  • CA Other: GR0046500 MEDICAL

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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