Summit Pediatric Medical Clinic Inc

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SUMMIT PEDIATRIC MEDICAL CLINIC INC

Practice address

29995 Technology Dr Ste A100
Murrieta, CA 92563-2632

Phone

(951) 412-1610

NPI assigned

Mar 15, 2021

Last updated

Mar 15, 2021By 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

Leon Yan, MDNPI 1962569228

Title

MD/Owner

Phone

(951) 412-1610

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Leon Yan, MD

  • Pediatrics Physician
  • Murrieta, CA
  • NPI 1962569228
  NPD Authorized official

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1841875515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29995 TECHNOLOGY DR STE A100",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632632",
            "telephone_number": "951-412-1610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29995 TECHNOLOGY DR STE A100",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632632",
            "telephone_number": "951-412-1610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT PEDIATRIC MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-05",
        "status": "A",
        "authorized_official_last_name": "YAN",
        "authorized_official_first_name": "LEON",
        "authorized_official_title_or_position": "MD/OWNER",
        "authorized_official_telephone_number": "951-412-1610",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacy Jean Styrcula
• Zahur-Saleh Subedar
• Lucille Mary Suffern, B.S, CPHT, CPT1
• Nicole Sugimoto, MA
• Steven Ellis Sultan, PH.D.
• Sunshine Family Therapy Services, Inc.
• Manu Surendran, NP
• Taylor Susdorf, PT
• Sussex Radiology
• Tabitha Michelle Suter

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.