Roseville Pediatric Medical Group, Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

029336 Issued in CA

Legal business name

ROSEVILLE PEDIATRIC MEDICAL GROUP, INC

Practice address

1098 Sunrise Ave Ste 100
Roseville, CA 95661-4469

Phone

(916) 789-1798

Fax

(916) 789-0889

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Jennell Mae Serda

Title

Manager

Phone

(916) 789-1798

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Ravinder Singh Khaira, MD

  • Pediatrics Physician
  • Sacramento, CA
  • NPI 1902842354
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1275647737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 SUNRISE AVE STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614469",
            "telephone_number": "916-789-1798",
            "fax_number": "916-789-0889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1098 SUNRISE AVE STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614469",
            "telephone_number": "916-789-1798",
            "fax_number": "916-789-0889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEVILLE PEDIATRIC MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "SERDA",
        "authorized_official_first_name": "JENNELL",
        "authorized_official_middle_name": "MAE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "916-789-1798",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "029336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roseville Optometry Associates
• Roseville Orthopedic Group a Medical Corp
• Roseville Orthopedic Physical Therapy Professional Corporation
• Roseville Orthopedics Group a Medical Corp
• Roseville Pain Management, Inc
• Roseville Point Health & Wellness Center LLC (Roseville Point Health & Wellness Center)
• Roseville Site for Vision Products, Inc. (Site for Sore Eyes 572)
• Roseville Surgery Center, LP (Roseville Surgery Center)
• Roseville Surgical Alliance Surgery Center, Inc.
• Roseville Surgical Alliance, Inc.

• Primary Care Clinic/Center in Roseville, CA
• Providers in Roseville, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.