Pediatric Care of Stockton

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PEDIATRIC CARE OF STOCKTON

Doing business as

Pediatric Care of Stockton

Practice address

2800 N California Street
Suite 14
Stockton, CA 95204-3759

Phone

(209) 464-2605

Fax

(209) 464-2711

NPI assigned

Dec 6, 2006

Last updated

Feb 23, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Suresh K Sachdeva, M.D.

Title

President

Phone

(209) 464-2695

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• PEDIATRIC CARE OF STOCKTON Doing business as

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

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Neta Duvdevany

  • Pediatrics Physician
  • Placerville, CA
  • NPI 1598180341
  NPD (past)
• Renu Mathews

  • Pediatrics Physician
  • Stockton, CA
  • NPI 1255642641
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1790844769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N CALIFORNIA STREET",
            "address_2": "SUITE 14",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043759",
            "telephone_number": "209-464-2605",
            "fax_number": "209-464-2711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N CALIFORNIA STREET",
            "address_2": "SUITE 14",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952043759",
            "telephone_number": "209-464-2605",
            "fax_number": "209-464-2711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC CARE OF STOCKTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "SACHDEVA",
        "authorized_official_first_name": "SURESH",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-464-2695",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A64522",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "A64522",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A645220",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEDIATRIC CARE OF STOCKTON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marquetta Pearson
• Anthony Edward Pedalino, PHARM.D.
• Laugatausala Kayla Ann Pedebone
• Robert E Pedersen, O.D.
• Pediatric Associates of Stockton
• Elio Pedroso Conroy, MD
• Rosa M Pedroza
• Peebles Family Care Home (PALS Assisted Living Services Inc)
• Peebles Family Care Home (PALS Assisted Living Services Inc)
• Sittie Reshyllaira Batara Peeples

• Pediatrics Physician in Stockton, CA
• Providers in Stockton, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.