South County Pediatric Medical Group

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SOUTH COUNTY PEDIATRIC MEDICAL GROUP

Practice address

680 W Tennyson Rd
Hayward, CA 94544-5236

Phone

(510) 782-4470

NPI assigned

Feb 16, 2007

Last updated

Jun 30, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tomas A Magana, M.D.

Title

Director

Phone

(510) 782-4470

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1366586356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5528 PACHECO BLVD",
            "address_2": "STE A",
            "city": "PACHECO",
            "state": "CA",
            "postal_code": "945535126",
            "telephone_number": "925-363-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 W TENNYSON RD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945445236",
            "telephone_number": "510-782-4470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH COUNTY PEDIATRIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "MAGANA",
        "authorized_official_first_name": "TOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "510-782-4470",
        "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": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.