Pediatric Acute Care Medical Associates, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A47742 Issued in CA

Legal business name

PEDIATRIC ACUTE CARE MEDICAL ASSOCIATES, INC.

Practice address

5353 Balboa Blvd
Suite 201
Encino, CA 91316-2804

Phone

(818) 788-5437

Fax

(818) 788-5436

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Carmen Julia Botero, MD

Title

Medical Director

Phone

(818) 788-5437

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1497821441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 571027",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913571027",
            "telephone_number": "818-788-5437",
            "fax_number": "818-788-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 BALBOA BLVD",
            "address_2": "SUITE 201",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913162804",
            "telephone_number": "818-788-5437",
            "fax_number": "818-788-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ACUTE CARE MEDICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "BOTERO",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "JULIA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-788-5437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A47742",
            "primary": true
        },
        {
            "code": "2080P0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CA",
            "license": "A47742",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "CA",
            "license": "A47742",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Panthea Pedoeim, NP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.