Rothtida Srey, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

20A13252 Issued in CA

Practice address

31573 Rancho Pueblo Rd Ste 102
Temecula, CA 92592-4854

Phone

(951) 528-2185

Fax

(951) 527-5651

NPI assigned

Jun 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DJEGCD/Endpoint/DJEGCD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Srey Pediatrics Medical Group PC

  • Pediatrics Physician
  • Temecula, CA
  • NPI 1609445287
  NPD Authorized official

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1093026411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 JASPER WAY",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920781154",
            "telephone_number": "515-707-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31573 RANCHO PUEBLO RD STE 102",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925924854",
            "telephone_number": "951-528-2185",
            "fax_number": "951-527-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SREY",
        "first_name": "ROTHTIDA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2022-09-06",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "20A13252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0020A1325200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric David Spratt, D.C.
• Kimberley Ann Springer, NCSP
• Kristen Danielle Springsteen, LMFT
• Tahjae Jewel Donyette Spruill
• Srey Pediatrics Medical Group PC
• St Dominic Hospice and Palliative Care Inc
• Crystal Elizabeth St John, STUDENT
• Teresa Stafford
• Tyler Stafford
• Elaine Helen Stahlhofen, M.S.

• Pediatrics Physician in Temecula, CA
• Providers in Temecula, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; 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.