NPIMap

Organization Active NPI

Specialty Medical Group - Dept of Perinatology

  • Maternal & Fetal Medicine Physician
  • Madera, CA
National Provider Identifier
1639445836
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
SPECIALTY MEDICAL GROUP - DEPT OF PERINATOLOGY
Practice address
9300 Valley Childrens PL
Mailstop FC25
Madera, CA 93636-8761
Phone
(559) 353-6700
Fax
(559) 353-6710
NPI assigned
Apr 2, 2012
Organization subpart
Yes
Parent organization
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Devonna Kaji, M.D.
Title
President
Phone
(559) 353-5700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X CA Primary

Addresses

Primary practice location

9300 Valley Childrens PL
Mailstop FC25
Madera, CA 93636-8761

Mailing address

9300 Valley Childrens PL
Mailstop FC25
Madera, CA 93636-8761
Phone (559) 353-6700

Other identifiers 1

IdentifierTypeStateIssuer
1013968296MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Vly Child Spec Med GRP Inc29 organizations share this tax ID, including this one
Part of
Vly Child Spec Med GRP Inc

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

9300 Valley Childrens Pl
#25
Madera, CA 93636
Phone (559) 353-6700

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1639445836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "address_2": "MAILSTOP FC25",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-6700",
            "fax_number": "559-353-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "address_2": "MAILSTOP FC25",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-6700",
            "fax_number": "559-353-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY MEDICAL GROUP - DEPT OF PERINATOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA INC",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "KAJI",
        "authorized_official_first_name": "DEVONNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-353-5700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013968296",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 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.