Organization Active NPI

South Pasadena Pediatrics, a Professional Corporation

  • Pediatrics Physician
  • South Pasadena, CA
National Provider Identifier
1750181236
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SOUTH PASADENA PEDIATRICS, A PROFESSIONAL CORPORATION
Practice address
1941 Huntington Dr Ste C
South Pasadena, CA 91030-4994
Phone
(626) 514-0315
NPI assigned
Mar 14, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Sandra Gildersleeve, MDNPI 1881091551
Title
Founder
Phone
(626) 514-0315

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1941 Huntington Dr Ste C
South Pasadena, CA 91030-4994

Mailing address

1941 Huntington Dr Ste C
South Pasadena, CA 91030-4994
Phone (626) 514-0315

Other names 1

  • South Pasadena Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2324671South Pasadena Pediatrics,1941 Huntington Drive, Suite C, South Pasadena, CA 91030Certificate of waiverMay 28, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1741910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1750181236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1941 HUNTINGTON DR STE C",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304994",
            "telephone_number": "626-514-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 HUNTINGTON DR STE C",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910304994",
            "telephone_number": "626-514-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PASADENA PEDIATRICS, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "GILDERSLEEVE",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "626-514-0315",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Pasadena Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.