Pediatric Rehab Med Assoc

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

A38652 Issued in CA

Legal business name

PEDIATRIC REHAB MED ASSOC

Practice address

747 52ND St
Oakland, CA 94609-1809

Phone

(510) 428-3655

Fax

(510) 450-5821

NPI assigned

Feb 27, 2007

Last updated

Aug 22, 2020By 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

Robert Haining, MDNPI 1396841680

Title

Head of Dept

Phone

(510) 428-3655

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Robert Rahn Haining, MD

  • Rehabilitation Practitioner
  • Oakland, CA
  • NPI 1396841680
  Authorized official Same address or phone

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881721108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 W MARCH LN",
            "address_2": "STE 200",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192369",
            "telephone_number": "209-473-6555",
            "fax_number": "209-473-6543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 52ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091809",
            "telephone_number": "510-428-3655",
            "fax_number": "510-450-5821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC REHAB MED ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAINING",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "HEAD OF DEPT",
        "authorized_official_telephone_number": "510-428-3655",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "CA",
            "license": "A38652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL #",
            "identifier": "GR0095340",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR HAINING'S CA MD LIC",
            "identifier": "A38652",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Therese Pedemonte, FNP, RN
• Pediatric Contracting Services, Inc.
• Pediatric Hematology Oncology
• Pediatric Imaging Medical Associates
• Pediatric Psychiatric Med Assoc Cho
• Pediatric Surgical Associates of the East Bay
• Annie Rose Pedlar, FNP, DNP
• Andrea Pedraza
• Donna Reimann Pedroza, LCSW
• Sofia Pedroza

• Pediatric Adolescent Medicine Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Pediatric Adolescent Medicine Physician in California

• 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.