NPIMap

Organization Active NPI

Kidiatrics Medical Group, Inc.

  • Pediatrics Physician
  • Rancho Santa Margarita, CA
National Provider Identifier
1841475738
Registry record updated Jan 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A069104 Issued in CA
Legal business name
KIDIATRICS MEDICAL GROUP, INC.
Practice address
22032 El Paseo
#160
Rancho Santa Margarita, CA 92688-3947
Phone
(949) 766-5001
Fax
(949) 766-5118
NPI assigned
Jan 9, 2008
Last updated
Jan 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2008

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

Authorized official

Name
Dr. Nivedita N More, M.D.
Title
Physican/President
Phone
(949) 766-5001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X A069104 CA Primary

Addresses

Primary practice location

22032 El Paseo
#160
Rancho Santa Margarita, CA 92688-3947

Mailing address

22032 El Paseo
#160
Rancho Santa Margarita, CA 92688-3947
Phone (949) 766-5001

Other identifiers 3

IdentifierTypeStateIssuer
ZZZ01773ZOtherCABLUE SHIELD OF CALIFORNIA
00A691040MedicaidCA
00A691040OtherCACALOPTIMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199836800000",
    "number": "1841475738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22032 EL PASEO",
            "address_2": "#160",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883947",
            "telephone_number": "949-766-5001",
            "fax_number": "949-766-5118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22032 EL PASEO",
            "address_2": "#160",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926883947",
            "telephone_number": "949-766-5001",
            "fax_number": "949-766-5118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDIATRICS MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-01-09",
        "status": "A",
        "authorized_official_last_name": "MORE",
        "authorized_official_first_name": "NIVEDITA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PHYSICAN/PRESIDENT",
        "authorized_official_telephone_number": "949-766-5001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A069104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CALIFORNIA",
            "identifier": "ZZZ01773Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A691040",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALOPTIMA",
            "identifier": "00A691040",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; 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.