NPIMap

Individual provider Active NPI

Paulina Jose Avendano, MD,FAAP

  • Pediatrics Physician
  • San Clemente, CA
National Provider Identifier
1982764858
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G077201 Issued in CA
Practice address
1300 Avenida Vista Hermosa
Suite 250
San Clemente, CA 92673
Phone
(949) 429-7700
Fax
(949) 429-7704
NPI assigned
Dec 11, 2006
Last updated
Mar 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G077201 CA Primary

Addresses

Primary practice location

1300 Avenida Vista Hermosa
Suite 250
San Clemente, CA 92673

Mailing address

638 Camino de Los Mares
H130-403
San Clemente, CA 92673
Phone (949) 682-5738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G077201CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Hospital Regional Medical Center Past Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Pediatric Subspecialty Faculty, Inc. Pediatrics Past Accepting new patients
Children's Hospital of Orange County Past Accepting new patients
Providence Health System Southern California Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332720000000",
    "number": "1982764858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 CAMINO DE LOS MARES",
            "address_2": "H130-403",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92673",
            "telephone_number": "949-682-5738",
            "fax_number": "949-326-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 AVENIDA VISTA HERMOSA",
            "address_2": "SUITE 250",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92673",
            "telephone_number": "949-429-7700",
            "fax_number": "949-429-7704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVENDANO",
        "first_name": "PAULINA",
        "middle_name": "JOSE",
        "name_prefix": "Dr.",
        "credential": "MD,FAAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2012-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G077201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; 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.