Pumphrey Patch Kidz, a Professional Medical Corporation

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PUMPHREY PATCH KIDZ, A PROFESSIONAL MEDICAL CORPORATION

Practice address

29798 Haun Rd Ste 304
Menifee, CA 92586-6542

Phone

(951) 679-3159

Fax

(951) 679-0250

NPI assigned

Sep 10, 2020

Organization subpart

No

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

Authorized official

Name

Kathryn Spaan

Title

Manager

Phone

(951) 679-3159

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.

• Charles David Pumphrey, M.D.

  • Pediatrics Physician
  • Sun City, CA
  • NPI 1043270531
  NPD (past)

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

{
    "created_epoch": "1599696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599696000000",
    "number": "1326653999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29798 HAUN RD STE 304",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925866542",
            "telephone_number": "951-679-3159",
            "fax_number": "951-679-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29798 HAUN RD STE 304",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925866542",
            "telephone_number": "951-679-3159",
            "fax_number": "951-679-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUMPHREY PATCH KIDZ, A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-10",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A",
        "authorized_official_last_name": "SPAAN",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "951-679-3159"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Behavioral Services LLC
• Premier Hospitalist & Post-Acute Group, Inc.
• Prestige Concierge Nursing
• Pruitt Optometric Eye Care LTD
• Joseph Allan Pruitt, O.D.
• Quality Mobile Imaging LLC
• Laurel Janene Quartaro, RDA
• Anna Marie Quesada, RDMS (ABD)
• Leslie Quezada
• Alyssa Ann-Marie Quick

• Pediatrics Physician in Menifee, CA
• Providers in Menifee, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.