Pacific Pediatrics Med GRP Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

207731 Issued in CA

Legal business name

PACIFIC PEDIATRICS MED GRP INC

Practice address

45 Castro Street
Suite 232
San Francisco, CA 94114

Phone

(415) 565-6810

Fax

(415) 565-6844

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

William Bernard Solomon, MD

Title

Treasurer

Phone

(415) 565-6810

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 5

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

• Ishita Aggarwal, MD

  • Rheumatology Physician
  • San Francisco, CA
  • NPI 1518385699
  NPD (past)
• Yasuko Fukuda, M.D.

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1285794511
  NPD (past)
• Sonja Jean Fong Huie, M.D.

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1972664399
  NPD (past)
• Diana Montgomery, M.D.

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1689618746
  NPD (past)
• Sara R Sullivan, M.D.

  • Pediatrics Physician
  • San Francisco, CA
  • NPI 1437165776
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366539884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CASTRO STREET",
            "address_2": "SUITE 232",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94114",
            "telephone_number": "415-565-6874",
            "fax_number": "415-565-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CASTRO STREET",
            "address_2": "SUITE 232",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94114",
            "telephone_number": "415-565-6810",
            "fax_number": "415-565-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PEDIATRICS MED GRP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "BERNARD",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "415-565-6810",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "207731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0026450",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pacific Neurodiagnostics LLC
• Pacific Neurophysiolgical Systems
• Pacific Neurophysiological Systems
• Pacific Oral Pathology Laboratory
• Pacific Pain Treatment Center
• Pacific Reproductive Services
• Pacific Reproductive Services, Inc.
• Pacific Rheumatology Associates Medical Group
• Pacific Specialist Surgical Center LLC (Hayes Valley Surgery Center)
• Pacific State Medical Group of California, P.C.

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