San Pedro Pediatrics Med GRP Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SAN PEDRO PEDIATRICS MED GRP INC

Practice address

1294 W 6TH St
Ste #102
San Pedro, CA 90731-2987

Phone

(310) 832-6487

Fax

(310) 832-6913

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Frank Brow, MD

Title

President

Phone

(310) 832-6487

Specialties & licenses 1

Addresses

Other identifiers 1

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 3

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

• Kenneth Earl Follmar III, MD

  • Pediatrics Physician
  • San Pedro, CA
  • NPI 1235437575
  NPD (past)
• Andrew P Novom, MD

  • Specialist
  • San Pedro, CA
  • NPI 1346295391
  NPD (past)
• Priscilla S Novom, MD

  • Specialist
  • San Pedro, CA
  • NPI 1518914191
  NPD (past)

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255446142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1294 W 6TH ST",
            "address_2": "STE #102",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312987",
            "telephone_number": "310-832-6487",
            "fax_number": "310-832-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1294 W 6TH ST",
            "address_2": "STE #102",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907312987",
            "telephone_number": "310-832-6487",
            "fax_number": "310-832-6913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN PEDRO PEDIATRICS MED GRP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROW",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-832-6487",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ43733Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• San Pedro Hospice Inc.
• San Pedro Hospitalist Medical Group Inc
• San Pedro Medical Clinic
• San Pedro OB-GYN Medical Corporation
• San Pedro Pain and Disc Institute Inc
• San Pedro Peninsula Hospital
• San Pedro Peninsula Hospital
• San Pedro Peninsula Hospital
• San Pedro Peninsula Hospital
• San Pedro Physical Therapy

• Pediatrics Physician in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.