Active NPI
Genevieve M Minka, MD
- Pediatrics Physician
- Temecula, CA
National Provider Identifier
1689646689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 877841
- Practice address
- 27699 Jefferson Ave
Suite 300
Temecula, CA 92590-2661 - Phone
- (951) 252-8588
- Fax
- (951) 252-8589
- NPI assigned
- Feb 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 877841 | CA | Primary |
Addresses
Primary practice location
27699 Jefferson Ave
Suite 300
Temecula, CA 92590-2661
Mailing address
27699 Jefferson Ave
Suite 300
Temecula, CA 92590-2661
Phone (951) 252-8588
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A77841 | Other | CA | MD LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 877841 | CA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marilyn Kaufhold, M.D., a Medical Corporation | Past | Accepting new patients |
Interoperability endpoints
- gminka11590@radychildrens.direct-ci.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Children's Hospital
- San Diego, CA
- NPI 1336359389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482969600000",
"number": "1689646689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27699 JEFFERSON AVE",
"address_2": "SUITE 300",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925902661",
"telephone_number": "951-252-8588",
"fax_number": "951-252-8589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27699 JEFFERSON AVE",
"address_2": "SUITE 300",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925902661",
"telephone_number": "951-252-8588",
"fax_number": "951-252-8589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINKA",
"first_name": "GENEVIEVE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-03",
"last_updated": "2016-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "877841",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD LICENSE",
"identifier": "A77841",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.