CLINICA MEDICA SAN PEDRO OF CALIFORNIA, INC (NPI# 1417271305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417271305 |
| Entity Type | Organization |
| Organization Name | CLINICA MEDICA SAN PEDRO OF CALIFORNIA, INC |
| Practice Address |
13939 San Antonio Dr Norwalk CA 90650-4036 |
| Practice Telephone | 5628631212 |
| Practice Fax Number | 5628641212 |
| Mailing Telephone | 5628631212 |
| Mailing Fax Number | 5628641212 |
| Enumeration Date | 2010-03-21 |
| Last Update Date | 2010-03-21 |
| Authorized Official Name | DR. JOSE MANUEL DIAZ (PRESIDENT) |
| Authorized Official Telephone | 5628631212 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207V00000X | Obstetrics & Gynecology | A39722 | CA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | A76805 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386927374 | Clinica Medica San Pedro of California, Inc | Pediatrics | 11725 Garvey Ave, Ste 5b, El Monte, CA 91732-4534 | 2011-09-26 |
| Street Address |
13939 SAN ANTONIO DR |
| City | NORWALK |
| State | CA |
| Zip Code | 90650-4036 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154403624 | Daniel K Wong | Family Medicine | 13939 San Antonio Dr, Norwalk, CA 90650-4036 | 2006-10-20 |
| 1578101531 | Ralph Allan Adiong Osorio | Nurse Practitioner | 13939 San Antonio Dr, Norwalk, CA 90650-4036 | 2019-12-20 |
| 1598223299 | Grupo Medico San Pedro Inc | Obstetrics & Gynecology | 13939 San Antonio Dr, Norwalk, CA 90650-4036 | 2019-03-12 |
| 1275913980 | Grupo Medico Del Carmen A Multy Specialty Medical Group, Inc | Obstetrics & Gynecology | 13939 San Antonio Dr, Norwalk, CA 90650-4036 | 2015-06-08 |
| 1295156982 | San Lucas Medical Clinic, Inc | General Practice | 13939 San Antonio Dr, Norwalk, CA 90650-4036 | 2013-12-23 |
| 1538227335 | Nicolas Dikio Md Inc | Obstetrics & Gynecology | 13939 San Antonio Dr, Norwalk, CA 90650-4036 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420316 | Ricky Chavez | Occupational Therapist | 13603 Halcourt Avenue, Norwalk, CA 90650 | 2020-09-03 |
| 1326671652 | Ryan Ly | Psychologist | 11400 Bloomfield Blvd, Norwalk, CA 90650 | 2020-02-14 |
| 1710416177 | Ricky O Lee | Pharmacist | 11401 S. Bloomfield Ave, Norwalk, CA 90650 | 2017-06-08 |
| 1689108847 | Eliana Segura | Student in an Organized Health Care Education/Training Program | 12440 Firestone Ave Blvd., 3020, Norwalk, CA 90650 | 2017-04-14 |
| 1396282752 | Martin Sanchez Torres | Specialist/Technologist, Other | 14003 Summer Ave, Norwalk, CA 90650 | 2017-01-24 |
| 1952859837 | Fatimah Busran | Social Worker | 11401 South Bloomfield Avde., Norwalk, CA 90650 | 2016-09-20 |
| 1760939383 | Andy Chang | Licensed Psychiatric Technician | 12440 East Imperial Highway, Suite 116, Norwalk, CA 90650 | 2016-09-01 |
| 1548634322 | Leslie Yesenia Lazo | Student in an Organized Health Care Education/Training Program | 12440 E. Firestone Blvd, Norwalk, CA 90650 | 2015-11-17 |
| 1306247994 | Ruth Vergara | Student in an Organized Health Care Education/Training Program | 21520 S. Pioneer Blvd., Suite 110, Hawaiian Gardens, CA 90650 | 2014-09-15 |
| 1265854251 | Sungmin Yee | Acupuncturist | 12706 Bloomfield Ave, Apt. 135, Norwalk, CA 90650 | 2014-01-10 |
| Find all providers in zip 90650 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780810796 | Jennifer Maureen Varghese | Pediatrics | 12632 Bloomfield Ave, Apt#23, Norwalk, CA 90650-8313 | 2009-06-04 |
| 1063589349 | Minerva A Lobarbio | Pediatrics | 13710 Studebaker Road #100, Norwalk, CA 90650 | 2006-11-29 |
| 1669559951 | Patricia Jorquera | Pediatrics | 10 Mott Avenue, 4th Floor, Norwalk, CT 06850 | 2006-11-01 |
| 1548213929 | Sharlita M. Rodgers-simpkins | Pediatrics | 12360 Firestone Blvd, Norwalk, CA 90650-4324 | 2006-05-18 |
| 1700887932 | Glenn John Trippe | Pediatrics | 282 Benedict Ave, Suite B, Norwalk, OH 44857-2712 | 2005-08-10 |
| 1386642932 | Catherine T Ford | Pediatrics | 10 Mott Avenue 4th Floor, Norwalk, CT 06850 | 2005-07-08 |
| 1437696093 | Fisher-titus Pediatrics LLC | Pediatrics | 282 Benedict Ave, Suite B, Norwalk, OH 44857-2712 | 2017-01-20 |
| 1154784627 | Elizabeth Frances Marie Olds | Pediatrics | 282 Benedict Ave Ste B, Norwalk, OH 44857-2712 | 2016-04-01 |
| 1578981858 | Sean Butler | Pediatrics | 40 Cross St, Norwalk, CT 06851-4647 | 2014-04-02 |
| 1902240849 | Aniqa Anwar | Pediatrics | 40 Cross St, Norwalk, CT 06851-4647 | 2013-04-22 |
| Find all providers in NORWALK | ||||
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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.