Kids Doc of Southern California Medical Group, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

KIDS DOC OF SOUTHERN CALIFORNIA MEDICAL GROUP, INC.

Practice address

27800 Medical Center Rd Suite 204
Mission Viejo, CA 92691

Phone

(949) 682-4750

Fax

(949) 682-4751

NPI assigned

May 9, 2006

Last updated

Nov 3, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Ann Wilkinson, M.D.NPI 1427103365

Title

Treasurer

Phone

(949) 951-5437

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Mary Ann Wilkinson, G067652

  • Pediatric Adolescent Medicine Physician
  • Laguna Hills, CA
  • NPI 1427103365
  Authorized official Same address or phone
• Cynthia A Dimalanta, MD

  • Pediatrics Physician
  • Rancho Santa Margarita, CA
  • NPI 1649310608
  NPD (past)
• George Yanni, M.D.

  • Pediatrics Physician
  • Loma Linda, CA
  • NPI 1942223425
  NPD (past)

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

{
    "created_epoch": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1013966670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD SUITE 204",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-682-4750",
            "fax_number": "949-682-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD SUITE 204",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "92691",
            "telephone_number": "949-682-4750",
            "fax_number": "949-682-4751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDS DOC OF SOUTHERN CALIFORNIA MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "949-951-5437",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lina Khanukayev, PT, DPT
• Bahareh Bahadori Khavarian, M.D.
• Nika Sara Khoobiyary
• Farhad Khorashadi, M.D.
• Alissa Nicole Khosla, LCSW
• Linda Christine Kiehlmeir, P.A-C
• Melanie Therese Kijel
• Jill Kilzer, RDMS, RVT
• Helen Kim-Whitehouse, LCSW
• Bonnie Jeone Kim, MD

• Pediatrics Physician in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.