Sonoma Plaza Pediatrics Medical Group, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A62474 Issued in CA

Legal business name

SONOMA PLAZA PEDIATRICS MEDICAL GROUP, INC.

Practice address

181 Andrieux Street St # 208
Sonoma, CA 95476-6920

Phone

(707) 935-9000

Fax

(707) 935-8374

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Charles Francis De Torres, M.D.NPI 1770510521

Title

M.D./Ceo

Phone

(707) 935-9000

Specialties & licenses 1

Addresses

Other identifiers 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

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

• Charles Francis De Torres, M.D.

  • Pediatrics Physician
  • Sonoma, CA
  • NPI 1770510521

  Pediatrics

  NPD (past) Authorized official
• Elizabeth Rose Gawron, M.D.

  • Pediatrics Physician
  • Sonoma, CA
  • NPI 1629013339

  Pediatrics

  NPD (past)
• Allison Margaret McKeany, MS, RD

  • Registered Dietitian
  • Sonoma, CA
  • NPI 1437456217
  NPD (past)

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1508973371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 ANDRIEUX STREET ST. # 208",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766920",
            "telephone_number": "707-935-9000",
            "fax_number": "707-935-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 ANDRIEUX STREET ST # 208",
            "city": "SONOMA",
            "state": "CA",
            "postal_code": "954766920",
            "telephone_number": "707-935-9000",
            "fax_number": "707-935-8374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA PLAZA PEDIATRICS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "DE TORRES",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "M.D./CEO",
        "authorized_official_telephone_number": "707-935-9000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A62474",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1770510521",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1407884919",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1629013339",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Sonoma, CA
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.