Private Pediatrics Incorporated

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A69540 Issued in CA

Legal business name

PRIVATE PEDIATRICS INCORPORATED

Practice address

3031 Telegraph Ave
Suite 235
Berkeley, CA 94705-2051

Phone

(888) 254-3950

Fax

(888) 254-3950

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Wolffe Nadoolman, M.D.

Title

Director

Phone

(888) 254-3950

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366524258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 TELEGRAPH AVE",
            "address_2": "SUITE 235",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052051",
            "telephone_number": "888-254-3950",
            "fax_number": "888-254-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 TELEGRAPH AVE",
            "address_2": "SUITE 235",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052051",
            "telephone_number": "888-254-3950",
            "fax_number": "888-254-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVATE PEDIATRICS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NADOOLMAN",
        "authorized_official_first_name": "WOLFFE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "888-254-3950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A69540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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