Pediatric Medical Associates of Tri-City, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC MEDICAL ASSOCIATES OF TRI-CITY, INC.

Doing business as

Pediatric Medical Associates

Practice address

2067 W Vista Way
Suite 180
Vista, CA 92083-6031

Phone

(760) 945-3434

Fax

(760) 945-6761

NPI assigned

Aug 14, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeannine Edwards

Title

Administrator

Phone

(760) 945-3434

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pediatric Medical Associates Doing business as

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275546095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "SUITE 180",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-945-3434",
            "fax_number": "760-945-6761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2067 W VISTA WAY",
            "address_2": "SUITE 180",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836031",
            "telephone_number": "760-945-3434",
            "fax_number": "760-945-6761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MEDICAL ASSOCIATES OF TRI-CITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "JEANNINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "760-945-3434"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0092060",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Medical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nick Pavlov, D.D.S.
• Thomas J Payne, D.C.
• Peaceful Promise, Inc (Peaceful Promise)
• Pear Tree Family Therapy, Inc.
• Pearl Dental Group
• Joanne Peet
• Dayna Jo Pendleton, COUNSELOR
• Marta Anne Penman, DDS
• Denilla Lizeth Perez-Llamas
• Denise Perez

• Pediatrics Physician in Vista, CA
• Providers in Vista, 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.