NPIMap

Organization Active NPI

Pleasant Valley Pediatric Medical Group

  • Pediatrics Physician
  • Camarillo, CA
National Provider Identifier
1942417340
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G33451 Issued in CA
Legal business name
PLEASANT VALLEY PEDIATRIC MEDICAL GROUP
Doing business as
Pleasant Valley Pediatric Medical Group
Practice address
2486 N Ponderosa Dr Ste D211
Camarillo, CA 93010-2376
Phone
(805) 484-2818
Fax
(805) 482-0028
NPI assigned
May 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Authorized official

Name
Dr. Michael G Gold, M.D.NPI 1215932058
Title
Partner
Phone
(805) 484-2818

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X G33451 CA Primary

Addresses

Primary practice location

2486 N Ponderosa Dr Ste D211
Camarillo, CA 93010-2376

Mailing address

2486 N Ponderosa Dr Ste D211
Camarillo, CA 93010-2470
Phone (805) 484-2818

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ75674ZMedicaidCA

Other names 1

  • Pleasant Valley Pediatric Medical Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1942417340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2486 N PONDEROSA DR STE D211",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102470",
            "telephone_number": "805-484-2818",
            "fax_number": "805-482-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2486 N PONDEROSA DR STE D211",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102376",
            "telephone_number": "805-484-2818",
            "fax_number": "805-482-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT VALLEY PEDIATRIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "GOLD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "805-484-2818",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G33451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ75674Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pleasant Valley Pediatric Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; 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.