The Pediatri Medical Group of Watsonville , Inc
Organization Active NPI Pediatrics Physician · Freedom, CA
NPI 1164563862 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1164563862
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pediatrics Physician 208000000X
- Legal business name
- THE PEDIATRI MEDICAL GROUP OF WATSONVILLE , INC
- Practice address
- 222 Green Valley Rd
Freedom, CA 95019-3136 - Phone
- (831) 728-2969
- Fax
- (831) 722-9604
- NPI assigned
- Feb 8, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Jeffrey A Roisman, MD
- Title
- President
- Phone
- (831) 728-2969
Practitioners 6
-
Carmen Philomena Hsu, M. D.
-
Deborah D Roisman, RNNP
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician |
208000000X | Yes |
Addresses
Primary practice location
222 Green Valley Rd
Freedom, CA 95019-3136
Mailing address
222 Green Valley Rd
Freedom, CA 95019-3136
Phone (831) 728-2969
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GROO86290 | Medicaid | CA |
Other providers in Freedom, CA
- Steven C Smith
- Sonus-USA, Inc.
- David Allen South
- Stacey C Hanlon MD PC
- Terry F. Haskin, D.D.S., Inc.
- Thomas M Leverone M D Inc
- Thrifty Payless Inc
- Valerie Tisone
- Chad Truong
- Chung Ngoc Truong
All providers in Freedom, CA · Pediatrics Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.