SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF RHEUMATOLOGY (NPI# 1316120298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316120298 |
| Entity Type | Organization |
| Organization Name | SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF RHEUMATOLOGY |
| Practice Address |
9300 Valley Childrens Pl Ge10 Madera CA 93636-8761 |
| Practice Telephone | 5593536450 |
| Practice Fax Number | 5593537214 |
| Mailing Telephone | 5593536450 |
| Mailing Fax Number | 5593537214 |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2007-12-13 |
| Authorized Official Name | RALPH P. DIAZ (PRESIDENT AND MEDICAL DIRECTOR) |
| Authorized Official Telephone | 5593535700 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0216X |
Pediatrics Specialization: Pediatric Rheumatology |
CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR007868K | 05 |
| Street Address |
9300 VALLEY CHILDRENS PL GE10 |
| City | MADERA |
| State | CA |
| Zip Code | 93636-8761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962405753 | Fred H Laningham | Radiology | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2005-05-24 |
| 1043811953 | Ashley Nicole Peton | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8762 | 2020-11-06 |
| 1063013308 | Samantha Carballo Austin | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-11-03 |
| 1982205217 | Stefanie Marie Gibbons | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-11-03 |
| 1114525128 | Kristin Leann Lokey | Social Worker | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-10-12 |
| 1770190969 | Mallory King | Physician Assistant | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-09-30 |
| 1356957161 | Sabrina Star Tovar | Audiologist | 9300 Valley Childrens Pl, Madera, CA 93636-8762 | 2020-09-17 |
| 1790391621 | Alyssa Catherine Nakaguchi | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8762 | 2020-09-16 |
| 1740894773 | Heather Goossen | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-09-08 |
| 1184236820 | Renzio Menico Bantayan Apostol | Pharmacist | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2020-08-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043695257 | Kati Pitts | Social Worker | 9300 Valley Children's Pl., Madera, CA 93636 | 2015-07-29 |
| 1386903177 | Christina Lee-ann Badgett | Registered Nurse | 40617 Rd 406, Madera, CA 93636 | 2012-05-14 |
| 1205134897 | Gina West | Counselor | 10120 Lanes Bridge Dr, Madera, CA 93636 | 2011-03-04 |
| 1326342593 | Re Zaw | Pediatrics | 9300 Valley Children's Place, Residency Dept (ge20), Madera, CA 93636 | 2011-01-03 |
| 1013144179 | Cynthia Romer Fata | Pathology | 9300 Valley Childrens Pl # Sc12, Madera, CA 93636 | 2009-06-16 |
| 1689815888 | Nasser Moiduddin | Pediatrics | 9300 Valley Childrens Pl # PC14, Madera, CA 93636 | 2009-03-18 |
| 1174503338 | James Clifton Horspool | Pediatrics | 9300 Valley Children's Place, Mb01, Madera, CA 93636 | 2006-01-21 |
| 1205818465 | James Weston Hole | Obstetrics & Gynecology | 9300 Valley Children's Pl, Fe16, Madera, CA 93636 | 2005-11-15 |
| 1679056493 | Catherine K. Beaumier | Surgery | 9300 Valley Children's Pl., Madera, CA 93636 | 2018-09-07 |
| 1912492216 | Ji Yeon Kwon | Registered Nurse | 9300 Valley Childrens Pl # Ge07, Madera, CA 93636 | 2018-06-28 |
| Find all providers in zip 93636 | ||||
| Taxonomy Code | 2080P0216X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Rheumatology |
| A pediatrician who treats diseases of joints, muscle, bones and tendons. A pediatric rheumatologist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750748224 | Valley Children's Medical Group - Dept of Rheumatology | Pediatrics | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2016-01-28 |
| 1598068736 | Sukesh Sukumaran | Pediatrics | 9300 Valley Childrens Pl # Ge10, Madera, CA 93636 | 2010-12-09 |
| 1861458002 | Edsel Arce-hernandez | Pediatrics | 9300 Valley Childrens Pl, Suite G270, Madera, CA 93638-8761 | 2006-04-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649298282 | Diane Elizabeth Brown | Pediatrics | 4650 Sunset Blvd., Los Angeles, CA 90027-6062 | 2006-07-18 |
| 1518413558 | George Lockie | Pediatrics | 100 Holland Gln, Apt 101, Escondido, CA 92026-1354 | 2016-08-30 |
| 1457694382 | Children's Hospital of Orange County | Pediatrics | 1201 W La Veta Ave, Orange, CA 92868-4203 | 2013-03-28 |
| 1356683031 | Meiqian Ma | Pediatrics | 725 Welch Rd, Palo Alto, CA 94304-1601 | 2013-03-20 |
| 1629356951 | Iris Reyhan | Pediatrics | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2011-08-03 |
| 1275858391 | Rebecca Stein Kunder | Pediatrics | 725 Welch Rd, Palo Alto, CA 94304-1601 | 2010-03-31 |
| 1720317753 | Ornella J Rullo | Pediatrics | 10833 Le Conte Ave, Mdcc 12-430, Los Angeles, CA 90095-1752 | 2009-12-22 |
| 1760649842 | Andrew Ira Shulman | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2008-05-17 |
| 1053582692 | Alice Dan-in Chang Hoftman | Pediatrics | 455 S Main St, Orange, CA 92868-3835 | 2008-03-21 |
| 1104001858 | Children's Hospital Los Angeles Medical Group | Pediatrics | 4650 W Sunset Blvd, Los Angeles, CA 90027-6062 | 2007-12-31 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.