Rebong Pediatric Medical Group, P.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

REBONG PEDIATRIC MEDICAL GROUP, P.C.

Practice address

145 N Jackson Ave
San Jose, CA 95116-1918

Phone

(408) 729-3232

Fax

(408) 729-2165

NPI assigned

May 1, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth P. Rebong, M.D.NPI 1326054776

Title

Pres.

Phone

(408) 729-3232

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, and the practitioner matching its NPPES authorized official.

• Kenneth Pomar Rebong, M.D.

  • General Practice Physician
  • San Jose, CA
  • NPI 1326054776
  Authorized official Same address or phone

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285855130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 N JACKSON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161918",
            "telephone_number": "408-729-3232",
            "fax_number": "408-729-2165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N JACKSON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161918",
            "telephone_number": "408-729-3232",
            "fax_number": "408-729-2165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBONG PEDIATRIC MEDICAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REBONG",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRES.",
        "authorized_official_telephone_number": "408-729-3232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therese Kathleen Reaney, DC
• Ivanna Reano
• Claudia Reay, M.D.
• Polina Rebenok
• Mitchell Reber
• Kenneth Pomar Rebong, M.D.
• Kiana E Rebugio
• Rebuilding Together Silicon Valley
• Marvin Recinos
• Laura-Ashley Recio, PSY

• Pediatrics Physician in San Jose, CA
• Providers in San Jose, 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.