NPIMap

Organization Active NPI

March Lane Pediatric Group

  • Pediatrics Physician
  • Stockton, CA
National Provider Identifier
1174868897
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A25317 Issued in CA
Legal business name
MARCH LANE PEDIATRIC GROUP
Practice address
73 W March LN Ste F
Stockton, CA 95207-5726
Phone
(209) 952-5555
Fax
(209) 952-1907
NPI assigned
Dec 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Authorized official

Name
Dr. Ange Mouttapa, M.D.
Title
Physician
Phone
(209) 952-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A25317 CA Primary

Addresses

Primary practice location

73 W March LN Ste F
Stockton, CA 95207-5726

Mailing address

73 W March LN Ste F
Stockton, CA 95207-5726
Phone (209) 952-5555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354752000000",
    "number": "1174868897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 W MARCH LN STE F",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075726",
            "telephone_number": "209-952-5555",
            "fax_number": "209-952-1907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 W MARCH LN STE F",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075726",
            "telephone_number": "209-952-5555",
            "fax_number": "209-952-1907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARCH LANE PEDIATRIC GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2012-12-06",
        "status": "A",
        "authorized_official_last_name": "MOUTTAPA",
        "authorized_official_first_name": "ANGE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "209-952-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A25317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.