Organization Active NPI

Foster City Pediatric Medical Group Inc

  • Pediatrics Physician
  • Foster City, CA
National Provider Identifier
1720179799
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FOSTER CITY PEDIATRIC MEDICAL GROUP INC
Practice address
1295 E Hillsdale Blvd
Foster City, CA 94404
Phone
(650) 574-2774
Fax
(650) 341-9236
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Subha Aahlad, MD
Title
Partner Ceo
Phone
(650) 574-2774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X CA Primary

Addresses

Primary practice location

1295 E Hillsdale Blvd
Foster City, CA 94404

Mailing address

1295 E Hillsdale Blvd
Foster City, CA 94404
Phone (650) 574-2774

Other identifiers 2

IdentifierTypeStateIssuer
GR0080460OtherCAMEDI-CAL
ZZZ17671ZOtherCABLUE SHIELD OF CA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720179799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 E HILLSDALE BLVD",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "94404",
            "telephone_number": "650-574-2774",
            "fax_number": "650-341-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1295 E HILLSDALE BLVD",
            "city": "FOSTER CITY",
            "state": "CA",
            "postal_code": "94404",
            "telephone_number": "650-574-2774",
            "fax_number": "650-341-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOSTER CITY PEDIATRIC MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AAHLAD",
        "authorized_official_first_name": "SUBHA",
        "authorized_official_title_or_position": "PARTNER CEO",
        "authorized_official_telephone_number": "650-574-2774",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "GR0080460",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ17671Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Foster City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.