NPIMap

Organization Active NPI

Orange County Children'S Medical Group, Inc.

  • Pediatrics Physician
  • Mission Viejo, CA
National Provider Identifier
1104066406
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A79073 Issued in CA
Legal business name
ORANGE COUNTY CHILDREN'S MEDICAL GROUP, INC.
Practice address
26691 Plaza Ste 120a
Mission Viejo, CA 92691-6347
Phone
(949) 600-8100
Fax
(949) 600-8101
NPI assigned
Feb 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

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

Authorized official

Name
Michael Villadelgado, M.D.NPI 1205885365
Title
Ceo
Phone
(949) 218-2869

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A79073 CA Primary

Addresses

Primary practice location

26691 Plaza Ste 120a
Mission Viejo, CA 92691-6347

Mailing address

26691 Plaza Ste 120a
Mission Viejo, CA 92691-6347
Phone (949) 600-8100

National Provider Directory

National Provider Directory

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260748800000",
    "number": "1104066406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26691 PLAZA STE 120A",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916347",
            "telephone_number": "949-600-8100",
            "fax_number": "949-600-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26691 PLAZA STE 120A",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916347",
            "telephone_number": "949-600-8100",
            "fax_number": "949-600-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE COUNTY CHILDREN'S MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-26",
        "last_updated": "2009-12-14",
        "status": "A",
        "authorized_official_last_name": "VILLADELGADO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-218-2869",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A79073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; 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.