Medten Medical Group Inc

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

A88977 Issued in CA

Legal business name

MEDTEN MEDICAL GROUP INC

Practice address

5767 Greenback LN
Suite 200
Sacramento, CA 95841-2013

Phone

(916) 220-6487

NPI assigned

Sep 20, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Naveen Manohar, M.D

Title

Vice President

Phone

(916) 220-6487

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379635200000",
    "number": "1235565300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3221 RAPALLO PL",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957625463",
            "telephone_number": "916-220-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5767 GREENBACK LN",
            "address_2": "SUITE 200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958412013",
            "telephone_number": "916-220-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDTEN MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-20",
        "last_updated": "2013-09-20",
        "status": "A",
        "authorized_official_last_name": "MANOHAR",
        "authorized_official_first_name": "NAVEEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "916-220-6487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A88977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Cardiology Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Pediatric Cardiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.