SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF UROLOGY (NPI# 1306029285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306029285 |
| Entity Type | Organization |
| Organization Name | SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF UROLOGY |
| Practice Address |
9300 Valley Childrens Pl Mb16 Madera CA 93636-8761 |
| Practice Telephone | 5593536195 |
| Practice Fax Number | 5593536196 |
| Mailing Telephone | 5593536195 |
| Mailing Fax Number | 5593536196 |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2007-12-13 |
| Authorized Official Name | RALPH 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 | 2088P0231X |
Urology Specialization: Pediatric Urology |
CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR007868L | 05 |
| Street Address |
9300 VALLEY CHILDRENS PL MB16 |
| 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 |
| Find all providers in the same location | ||||
| 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 | 2088P0231X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| Specialization | Pediatric Urology |
| Surgeons who can diagnose, treat, and manage children’s urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). |
| Notes: Source: American Academy of Pediatrics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013374586 | Valley Children's Medical Group - Dept of Urology | Urology | 9300 Valley Childrens Pl, Madera, CA 93636-8761 | 2016-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790326825 | Faculty Physicians and Surgeons of Llusm | Urology | 11360 Mt View Ave Ste B, Loma Linda, CA 92354-3834 | 2019-09-30 |
| 1124416813 | Igal Silber | Urology | 2645 Nido Way, Laguna Beach, CA 92651-4024 | 2015-01-02 |
| 1922430016 | Alan M Freedman M D Inc | Urology | 401 Old Newport Blvd Ste 101, Newport Beach, CA 92663-4276 | 2013-07-31 |
| 1639449614 | Herbert Schwarz | Urology | 12011 Theta Rd, Santa Ana, CA 92705-3328 | 2012-01-06 |
| 1518194935 | Renea Sturm | Urology | 200 Ucla Medical Plz Ste 170, Los Angeles, CA 90095-8344 | 2009-06-11 |
| 1295900439 | Faculty Physicians and Surgeons of Llusm | Urology | 11370 Anderson St Ste 2050, Loma Linda, CA 92354-3450 | 2008-04-29 |
| 1598938243 | Jennifer Hsueh-lin Yang | Urology | Ucsf Department of Urology, 400 Parnassus Avenue, A633, San Francisco, CA 94143-0001 | 2008-04-02 |
| 1386829034 | University Childrens Medical Group | Urology | 4650 W Sunset Blvd # 114, Los Angeles, CA 90027-6062 | 2007-12-31 |
| 1255522538 | Andy Yu-how Chang | Urology | 6430 W Sunset Blvd Ste 600, Los Angeles, CA 90028-7909 | 2007-08-05 |
| 1851500573 | Hillary L Copp | Urology | Ucsf Dept of Urology, 400 Parnassus Ave, San Francisco, CA 94143-0001 | 2007-05-21 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF UROLOGY.
| 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.