NPIMap

Organization Active NPI

Pediahealth Medical Group, Inc.

  • Clinic/Center
  • Daly City, CA
National Provider Identifier
1003913971
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
A32383 Issued in CA
Legal business name
PEDIAHEALTH MEDICAL GROUP, INC.
Practice address
901 Campus Dr
Suite 210
Daly City, CA 94015-4900
Phone
(650) 994-3000
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ofelia Maristela, M.D.NPI 1033264122
Title
Chief Medical Officer
Phone
(650) 994-3000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X A32383 CA Primary

Addresses

Primary practice location

901 Campus Dr
Suite 210
Daly City, CA 94015-4900

Mailing address

901 Campus Dr
Suite 210
Daly City, CA 94015-4900
Phone (650) 994-3000

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003913971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DR",
            "address_2": "SUITE 210",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154900",
            "telephone_number": "650-994-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CAMPUS DR",
            "address_2": "SUITE 210",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154900",
            "telephone_number": "650-994-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIAHEALTH MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARISTELA",
        "authorized_official_first_name": "OFELIA",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "650-994-3000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A32383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.