NPIMap

Organization Active NPI

Pediatric & Adolescent Medical Assoc. of the Pacific Coast

  • Pediatrics Physician
  • Salinas, CA
National Provider Identifier
1992899942
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC & ADOLESCENT MEDICAL ASSOC. OF THE PACIFIC COAST
Practice address
260 San Jose St
Salinas, CA 93901-3901
Phone
(831) 757-8124
Fax
(731) 757-4790
NPI assigned
Oct 3, 2006
Last updated
Sep 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

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

Authorized official

Name
Mrs. Connie K. Kellough
Title
Cao
Phone
(831) 757-8124

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Primary

Addresses

Primary practice location

260 San Jose St
Salinas, CA 93901-3901

Mailing address

260 San Jose St
Salinas, CA 93901-3901
Phone (831) 757-8124

Other identifiers 1

IdentifierTypeStateIssuer
GR009600MedicaidCA

National Provider Directory

National Provider Directory

Locations

260 San Jose St
Salinas, CA 93901
Phone (831) 757-8124

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221609600000",
    "number": "1992899942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 SAN JOSE ST",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013901",
            "telephone_number": "831-757-8124",
            "fax_number": "731-757-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 SAN JOSE ST",
            "city": "SALINAS",
            "state": "CA",
            "postal_code": "939013901",
            "telephone_number": "831-757-8124",
            "fax_number": "731-757-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC & ADOLESCENT MEDICAL ASSOC. OF THE PACIFIC COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-09-17",
        "status": "A",
        "authorized_official_last_name": "KELLOUGH",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "831-757-8124",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR009600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salinas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; 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.