NPIMap

Organization Active NPI

Eureka Pediatrics Medical Practice

  • Pediatric Adolescent Medicine Physician
  • McKinleyville, CA
National Provider Identifier
1669775730
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
EUREKA PEDIATRICS MEDICAL PRACTICE
Practice address
2192 Central Ave
McKinleyville, CA 95519-3610
Phone
(707) 839-3377
Fax
(707) 839-3612
NPI assigned
Dec 13, 2010
Organization subpart
Yes
Parent organization
EUREKA PEDIATRICS MEDICAL PRACTICEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Authorized official

Name
Mrs. Elesha L Hernandez
Title
Administrator
Phone
(707) 445-9413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X CA Primary

Addresses

Primary practice location

2192 Central Ave
McKinleyville, CA 95519-3610

Mailing address

2800 Harris St
Eureka, CA 95503-4809
Phone (707) 445-9413

Other identifiers 1

IdentifierTypeStateIssuer
553849OtherCARURAL HEALTH NUMBER

Other names 1

  • Eureka Pediatrics McKinleyville Office Doing business as

National Provider Directory

National Provider Directory
Part of
Eureka Pediatrics

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

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": "1292198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1669775730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 HARRIS ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034809",
            "telephone_number": "707-445-9413",
            "fax_number": "707-445-4182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2192 CENTRAL AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955193610",
            "telephone_number": "707-839-3377",
            "fax_number": "707-839-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUREKA PEDIATRICS MEDICAL PRACTICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EUREKA PEDIATRICS MEDICAL PRACTICE",
        "enumeration_date": "2010-12-13",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "ELESHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "707-445-9413",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RURAL HEALTH NUMBER",
            "identifier": "553849",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eureka Pediatrics McKinleyville Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in McKinleyville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.