The Children'S Doctor Professional Corporation

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A79434 Issued in CA

Legal business name

THE CHILDREN'S DOCTOR PROFESSIONAL CORPORATION

Practice address

3975 Jackson St
Suite 207
Riverside, CA 92503-3901

Phone

(951) 352-2092

Fax

(951) 352-1913

NPI assigned

Sep 16, 2008

Organization subpart

No

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

Authorized official

Name

Judith M BedoyNPI 1396831145

Title

Director

Phone

(951) 352-2092

Specialties & licenses 1

Addresses

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 1

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

• Judith M Bedoy, M.D

  • Pediatrics Physician
  • Riverside, CA
  • NPI 1396831145
  NPD (past) Authorized official

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1194974972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3975 JACKSON ST",
            "address_2": "SUITE 207",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033901",
            "telephone_number": "951-352-2092",
            "fax_number": "951-352-1913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 JACKSON ST",
            "address_2": "SUITE 207",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033901",
            "telephone_number": "951-352-2092",
            "fax_number": "951-352-1913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHILDREN'S DOCTOR PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "BEDOY",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "951-352-2092"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A79434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Carolyn E. Wylie Center
• The Carolyn E. Wylie Center
• The Carolyn E. Wylie Center for Children, Youth & Families
• The Carolyn E.Wylie Center for Children, Youth & Families
• The Chaun Collective
• The Dental Office on Magnolia, Inc
• The Diet Duchess LLC
• The Emmanuel Project
• The Emmanuel Project
• The Emmanuel Project

• Pediatrics Physician in Riverside, CA
• Providers in Riverside, 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 16, 2008; 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.