Pediatric Primary Care Associated Medical Group

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

G393080 Issued in CA

Legal business name

PEDIATRIC PRIMARY CARE ASSOCIATED MEDICAL GROUP

Practice address

550 Washington St
Ste 300
San Diego, CA 92103-2213

Phone

(619) 757-1468

Fax

(619) 243-0722

NPI assigned

Apr 15, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Stephen H Carson, M.D.

Title

President

Phone

(619) 757-1468

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302825600000",
    "number": "1356631972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST",
            "address_2": "STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032213",
            "telephone_number": "619-757-1468",
            "fax_number": "619-243-0722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST",
            "address_2": "STE 300",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032213",
            "telephone_number": "619-757-1468",
            "fax_number": "619-243-0722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC PRIMARY CARE ASSOCIATED MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-15",
        "last_updated": "2011-04-15",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-757-1468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": "G393080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Marie Pedgrift, PSY.D.
• Pediatric Cardiology of San Diego
• Pediatric Neurology Therapeutics
• Pediatric Office Anesthesia Specialists
• Pediatric Orthopedic and Scoliosis Center of San Diego, Inc.
• Pediatric Specialty Partners Inc.
• Celeste Pedraza
• Kassandra Pedraza
• Maritzabel Pedrazzini
• Christian Pedretti, L.AC.

• Health Maintenance Organization in San Diego, CA
• Providers in San Diego, CA by specialty
• Health Maintenance Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2011; 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.