East Sacramento Pediatric Medical Group Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

EAST SACRAMENTO PEDIATRIC MEDICAL GROUP INC

Practice address

5030 J St Ste 301
Sacramento, CA 95819-3800

Phone

(916) 451-8430

NPI assigned

Dec 19, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Ravinder Singh Khaira, MDNPI 1902842354

Title

Owner/Physician

Phone

(916) 451-8430

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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.

• Ravinder Singh Khaira, MD

  • Pediatrics Physician
  • Sacramento, CA
  • NPI 1902842354
  NPD (past) Authorized official

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

{
    "created_epoch": "1576713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1093353195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 J ST STE 301",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193800",
            "telephone_number": "916-451-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 J ST STE 301",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958193800",
            "telephone_number": "916-451-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SACRAMENTO PEDIATRIC MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-19",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "KHAIRA",
        "authorized_official_first_name": "RAVINDER",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "916-451-8430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588600431",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811383490",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902842354",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• East Sacramento Physical Therapy, Inc
• Kayla M Eastburn
• Easter Seal Society of Superior California (Easter Seals Superior California)
• Easter Seal Society of Superior California (Easter Seals Superior)
• Easter Seal Society of Superior California (Easter Seals Superior California)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2019; 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.