NPIMap

Organization Active NPI

Laguna Hills Pediatric Medical Group, Inc.

  • Pediatrics Physician
  • Laguna Hills, CA
National Provider Identifier
1962542159
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G320830 Issued in CA
Legal business name
LAGUNA HILLS PEDIATRIC MEDICAL GROUP, INC.
Practice address
24953 Paseo de Valencia
#5A
Laguna Hills, CA 92653-4342
Phone
(949) 951-1376
Fax
(949) 951-6378
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dennis S Phillips, MDNPI 1003956350
Title
President
Phone
(949) 951-1376

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X G320830 CA Primary

Addresses

Primary practice location

24953 Paseo de Valencia
#5A
Laguna Hills, CA 92653-4342

Mailing address

24953 Paseo de Valencia
#5A
Laguna Hills, CA 92653-4342
Phone (949) 951-1376

Other names 1

  • Laguna Viejo Pediatric Medical Group, Inc. Former legal business name

National Provider Directory

National Provider Directory

Locations

24953 Paseo de Valencia
Ste 5A
Laguna Hills, CA 92653
Phone (949) 297-3838

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962542159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24953 PASEO DE VALENCIA",
            "address_2": "#5A",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534342",
            "telephone_number": "949-951-1376",
            "fax_number": "949-951-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24953 PASEO DE VALENCIA",
            "address_2": "#5A",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926534342",
            "telephone_number": "949-951-1376",
            "fax_number": "949-951-6378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGUNA HILLS PEDIATRIC MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-951-1376",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G320830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Laguna Viejo Pediatric Medical Group, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Laguna Hills, CA

Sources for this page

  • 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.