SAN DIEGO UPTOWN PEDIATRIC MEDICAL GROUP, INC (NPI# 1700342748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700342748 |
| Entity Type | Organization |
| Organization Name | SAN DIEGO UPTOWN PEDIATRIC MEDICAL GROUP, INC |
| Practice Address |
3500 Fifth Ave Ste 101 San Diego CA 92103-5020 |
| Practice Telephone | 6192953911 |
| Practice Fax Number | 6192954356 |
| Mailing Telephone | 6192953911 |
| Mailing Fax Number | 6192954356 |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-02-14 |
| Authorized Official Name | HILARY KRAUSE (PHYSICIAN/CO-PRESIDENT) |
| Authorized Official Telephone | 6192953911 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| Street Address |
3500 FIFTH AVE STE 101 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-5020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| 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 |
|---|---|---|---|---|
| 1467976340 | Cheryl Adele Burian | Pediatrics | 6572 Cascade St, San Diego, CA 92122-2425 | 2017-08-01 |
| 1043747819 | Karen Chan | Pediatrics | 3030 Childrens Way Fl 4, San Diego, CA 92123-4232 | 2017-05-11 |
| 1922462209 | Meaghan Wido | Pediatrics | Naval Medical Ctr 34800 Bob Wilson Drive, San Diego, CA 92134-5000 | 2016-04-12 |
| 1427434679 | Coast Pediatrics Carmel Valley | Pediatrics | 5965 Village Drive, Suite 201, San Diego, CA 92130 | 2015-08-10 |
| 1194104521 | Charles E Pohl IIi | Pediatrics | 3020 Childrens Way # Mc5065, San Diego, CA 92123-4223 | 2015-05-18 |
| 1477948479 | Thuan Diep | Pediatrics | 12036 Scripps Highlands Dr Ste 102, San Diego, CA 92131-5155 | 2015-04-06 |
| 1518352970 | Karen Ki Won Lee | Pediatrics | 3020 Childrens Way # Mc5035, San Diego, CA 92123-4223 | 2015-04-02 |
| 1730594235 | Jessie Su Bowers | Pediatrics | 12036 Scripps Highlands Dr # 102, San Diego, CA 92131-5155 | 2014-06-24 |
| 1154683043 | Daniel Micah Lichtmann | Pediatrics | 15004 Innovation Drive, San Diego, CA 92128 | 2012-06-15 |
| 1740540558 | Gordon Chih-jen Cheng | Pediatrics | 12036 Scripps Highlands Dr, Ste 102, San Diego, CA 92131-5155 | 2012-05-26 |
| Find all providers in SAN DIEGO | ||||
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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.