MINDFUL PEDIATRIC GASTROENTEROLOGY, INC (NPI# 1790186112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790186112 |
| Entity Type | Organization |
| Organization Name | MINDFUL PEDIATRIC GASTROENTEROLOGY, INC |
| Practice Address |
65 N Madison Ave Suite 709 Pasadena CA 91101-2035 |
| Practice Telephone | 6268004059 |
| Practice Fax Number | 6268003974 |
| Mailing Telephone | 6268004059 |
| Mailing Fax Number | 6268003974 |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2014-09-09 |
| Authorized Official Name | DR. GILBERTO BULTRON (CEO) |
| Authorized Official Telephone | 6268004059 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
A106843 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
65 N MADISON AVE SUITE 709 |
| City | PASADENA |
| State | CA |
| Zip Code | 91101-2035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427053693 | Bianca Grigorian | Internal Medicine | 65 N Madison Ave, Ste 800, Pasadena, CA 91101-2038 | 2005-06-15 |
| 1407308802 | Hilary Ruiz | Audiologist | 65 N Madison Ave, Suite #201, Pasadena, CA 91101-2035 | 2016-11-01 |
| 1841607835 | Reach Wellness & Recovery Incorporated | Anesthesiology | 65 N Madison Ave, Suite 202, Pasadena, CA 91101-2035 | 2014-07-22 |
| 1356771315 | Ellen Miller Kwon, Psyd | Psychologist | 65 N Madison Ave, Suite 405, Pasadena, CA 91101-2035 | 2013-11-12 |
| 1396085635 | Eric Harlacher | Counselor | 65 N Madison Ave, Suite 302, Pasadena, CA 91101-2035 | 2013-02-24 |
| 1336483973 | Hillary Mastrosimone | Marriage & Family Therapist | 65 N Madison Ave, Suite 302, Pasadena, CA 91101-2035 | 2012-11-20 |
| 1750634192 | Cnc Pharmacy Inc | Pharmacy | 65 N Madison Ave, Pasadena, CA 91101 | 2012-10-23 |
| 1184976250 | James R. Esther,m.d.,inc | Dermatology | 65 N Madison Ave, Suite 409, Pasadena, CA 91101-2035 | 2012-10-12 |
| 1053680306 | Pacific Reproductive Services, Inc. | Nurse Practitioner | 65 N Madison Ave, Suite 610, Pasadena, CA 91101-2035 | 2011-12-15 |
| 1467762633 | Lynn Marie Henning | Marriage & Family Therapist | 65 N Madison Ave, Suite 302, Pasadena, CA 91101-2035 | 2010-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720696404 | Sophia Ting-jan Liang | Student in an Organized Health Care Education/Training Program | 98 S. Los Robles Ave., Kaiser Permanente Bernard J. Tyson School of Medicine, Pasdena, CA 91101 | 2020-07-17 |
| 1851917033 | Casa De Las Amigas | Lodging | 173 N Oak Knoll Ave, Pasadena, CA 91101 | 2020-06-23 |
| 1467076869 | Tong Qi | Student in an Organized Health Care Education/Training Program | Kaiser Permanente Bernard Kj. Tyson School of Medicine, Pasadena, CA 91101 | 2020-06-01 |
| 1386267839 | Kelly B Shriver | Student in an Organized Health Care Education/Training Program | Kaiser Permanente Bernard J. Tyson School of Medicine, 98 S. Los Robles, Pasadena, CA 91101 | 2020-05-19 |
| 1427600758 | Brooke Danielle Pechman | Marriage & Family Therapist | 221 E Walnut Street, Suite 138, Pasadena, CA 91101 | 2019-07-16 |
| 1952897563 | Robert Howes Hambleton | Dentist | 200 S. Oak Knoll Ave #201, Pasadena, CA 91101 | 2018-07-06 |
| 1801306774 | Joseph Hendrix | Social Worker | 1500 South Mcdonnell Avenue, Commerce, CA 91101 | 2017-10-05 |
| 1730606070 | Candice Anne Watson | Nurse Practitioner | 350 South Madison Ave #322, Pasadena, CA 91101 | 2017-08-28 |
| 1700320223 | Jenny H. Pak | Psychologist | 180 N. Oakland Ave., Pasadena, CA 91101 | 2016-12-19 |
| 1578005401 | James Maddox | Student in an Organized Health Care Education/Training Program | 447 El Molino Ave, Pasadena, CA 91101 | 2016-11-09 |
| Find all providers in zip 91101 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| 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 |
|---|---|---|---|---|
| 1134531254 | Mary Catherine Sawh | Pediatrics | 1625 Stockton Blvd Ste 105, Sacramento, CA 95816-7098 | 2014-05-22 |
| 1477899474 | Thomas W Self | Pediatrics | 7514 Girard Ave Ste 1, La Jolla, CA 92037-5199 | 2012-12-19 |
| 1174882047 | Marwa Abu El Haija | Pediatrics | 3801 Sacramento St Ste 216, San Francisco, CA 94118 | 2012-05-11 |
| 1518251636 | Travis Loyd Piester | Pediatrics | 4650 W Sunset Blvd # Ms 76, Los Angeles, CA 90027-6062 | 2011-06-06 |
| 1235422197 | Emily Whang | Pediatrics | 10833 Le Conte Ave # 12-383, Los Angeles, CA 90095-2804 | 2011-05-25 |
| 1851616056 | Kelly Beth Haas | Pediatrics | 2516 Stockton Blvd Ste 367, Sacramento, CA 95817-2208 | 2010-03-30 |
| 1538490230 | Pediatric Gastroenterology of Monterey Inc. | Pediatrics | 1900 Garden Road Suite 110, Pediatric Group of Monterey, Monterey, CA 93940 | 2010-01-19 |
| 1750562864 | Fadi G. Haddad, Md, Inc | Pediatrics | 1455 Montego, Suite 101, Walnut Creek, CA 94598 | 2007-11-16 |
| 1558490912 | Khyati Pravin Mehta | Pediatrics | 25845 Barton Rd Ste 101, Loma Linda, CA 92354-5300 | 2007-03-03 |
| 1841341427 | Walter Edward Benkert Sipe | Pediatrics | 500 Parnasus Ave, Box 0136, San Francisco, CA 94143-0136 | 2007-01-12 |
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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.