SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF ORTHOPEDICS (NPI# 1972784353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972784353 |
| Entity Type | Organization |
| Organization Name | SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF ORTHOPEDICS |
| Practice Address |
9300 Valley Childrens Pl Fe10 Madera CA 93636-8761 |
| Practice Telephone | 5593535941 |
| Practice Fax Number | 5593535945 |
| Mailing Telephone | 5593535941 |
| Mailing Fax Number | 5593535945 |
| Enumeration Date | 2007-11-14 |
| Last Update Date | 2013-06-28 |
| Authorized Official Name | DEVONNA M. KAJI (PRESIDENT / 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 |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | CA | Allopathic & Osteopathic Physicians | |
| Y | 207X00000X | Orthopaedic Surgery | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SMG GENERAL GROUP NPI NUMBER | 1013968296 | 01 |
| CA | GR007868N | 05 |
| Street Address |
9300 VALLEY CHILDRENS PL FE10 |
| 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 |
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| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952479180 | Cyril William Rebel | Orthopaedic Surgery | 550 East Almond Avenue, Suite A, Madera, CA 93637 | 2006-12-04 |
| 1225497704 | Valley Children's Medical Group - Dept of Orthopedics | Orthopaedic Surgery | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2016-02-12 |
| 1114127685 | Purushottam Arjun Gholve | Orthopaedic Surgery | 9300 Valley Childrens Pl # Fe10, Madera, CA 93636-8761 | 2007-07-23 |
| 1215974563 | Jon E Oda | Orthopaedic Surgery | 9300 Valley Childrens Pl # Fe10, Madera, CA 93636-8761 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163382 | San Bernardino Medical Orthopaedic Group Inc | Orthopaedic Surgery | 8805 Haven Ave Ste 100, Rancho Cucamonga, CA 91730-5149 | 2020-10-30 |
| 1376142067 | San Bernardino Medical Orthopaedic Gro | Orthopaedic Surgery | 4500 Brockton Ave Ste 306, Riverside, CA 92501-4027 | 2020-10-22 |
| 1699372326 | Adventist Health Physicians Network | Orthopaedic Surgery | 84 Madrone St Ste A, Willits, CA 95490-4249 | 2020-10-06 |
| 1982215992 | Roshan T Melvani Md Inc | Orthopaedic Surgery | 12677 Hesperia Rd Ste 140, Victorville, CA 92395-7735 | 2020-08-13 |
| 1164033684 | First Care Multispecialty Medical Group, Inc. | Orthopaedic Surgery | 4401 Atlantic Ave Ste 480, Long Beach, CA 90807-2265 | 2020-08-10 |
| 1194343855 | Orthopaedic Group of Orange County | Orthopaedic Surgery | 1200 N Tustin Ave Ste 250, Santa Ana, CA 92705-3596 | 2020-07-09 |
| 1497372536 | Kaley Brown Surgical Pa | Orthopaedic Surgery | 360 Tom Mcguinness Jr Cir, Fallbrook, CA 92028-2623 | 2020-07-05 |
| 1982220612 | Advanced Orthopaedic Surgeons At Long Beach, Inc | Orthopaedic Surgery | 1760 Termino Ave Ste 208, Long Beach, CA 90804-2151 | 2020-06-18 |
| 1982227609 | Sun Medical Group Huntington, Inc | Orthopaedic Surgery | 7801 Center Ave Ste 203, Huntington Beach, CA 92647-9118 | 2020-05-28 |
| 1932722733 | Julian Hakim Baloyan | Orthopaedic Surgery | 333 H St Ste 5000503, Chula Vista, CA 91910-5555 | 2020-05-27 |
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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.