SOUTH COUNTY PEDIATRIC MEDICAL GROUP (NPI# 1366586356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366586356 |
| Entity Type | Organization |
| Organization Name | SOUTH COUNTY PEDIATRIC MEDICAL GROUP |
| Practice Address |
680 W Tennyson Rd Hayward CA 94544-5236 |
| Mailing Address |
5528 Pacheco Blvd Ste A Pacheco CA 94553-5126 |
| Practice Telephone | 5107824470 |
| Mailing Telephone | 9253638170 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2008-06-30 |
| Authorized Official Name | TOMAS A MAGANA (DIRECTOR) |
| Authorized Official Telephone | 5107824470 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0102930 | 05 |
| Street Address |
680 W TENNYSON RD |
| City | HAYWARD |
| State | CA |
| Zip Code | 94544-5236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669546230 | Anne Robinson Job | Social Worker | 680 W Tennyson Rd, Hayward, CA 94544-5236 | 2006-11-17 |
| 1699264754 | The Alliance for Community Wellness | Community/Behavioral Health | 680 W Tennyson Rd, Hayward, CA 94544-5236 | 2018-05-04 |
| 1508226739 | Mayra Guadalupe Guizar | Case Manager/Care Coordinator | 680 W Tennyson Rd, Hayward, CA 94544-5236 | 2016-03-01 |
| 1700274651 | Iveta Markova-mitev | Dentist | 680 W Tennyson Rd, Hayward, CA 94544-5236 | 2014-12-30 |
| 1225327737 | Tiburcio Vasquez Health Center, Inc. | Case Management | 680 W Tennyson Rd, Hayward, CA 94544-5236 | 2011-04-05 |
| 1366606238 | Lee Ann Turner | Registered Nurse | 680 W Tennyson Rd, Hayward, CA 94544-5236 | 2008-07-10 |
| 1023225828 | Hayward Sisters Hospital | Dentist | 680 W Tennyson Rd, Hayward, CA 94544-5236 | 2007-05-17 |
| 1861521692 | Michael L French | Dentist | 680 W Tennyson Rd, Hayward, CA 94544-5236 | 2007-03-05 |
| 1639208473 | Roxanne Cohen | Dentist | 680 W Tennyson Rd, Hayward, CA 94544-5236 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659845147 | Yves Richard Preval | Respiratory Therapist, Registered | 29843 Baltic Ct, Hayward, CA 94544 | 2019-01-17 |
| 1578044764 | Dionisia Maria Inocencio | Psychologist | 24823 Soto Rd, Hayward, CA 94544 | 2018-08-24 |
| 1235642307 | Ana Cecilia Contreras | Counselor | 550 Berry Ave, 1, Hayward, CA 94544 | 2017-11-13 |
| 1528580990 | Mind Fitness Center | Counselor | 225 West. Winton Ave, Suite 202d, Hayward, CA 94544 | 2017-07-07 |
| 1831628262 | Edith Mcneal | Counselor | 31518 Medinah St., Hayward, CA 94544 | 2017-06-08 |
| 1629456520 | Kevin Porciuncula | Family Medicine | 1251 W Tennyson Rd Ste 4, Hayward, CA 94544 | 2015-05-12 |
| 1104226273 | Mohamed Conteh | Social Worker | 555 Sycamore Avenue #4, Hayward, CA 94544 | 2014-08-26 |
| 1386993558 | Jose Angel Gonzalez Jr. | Counselor | 107 Jackson St., Hayward, CA 94544 | 2012-09-04 |
| 1003171828 | Alameda County Public Health Nursing | Public Health or Welfare | 24085 Amador, Hayward, CA 94544 | 2012-07-09 |
| 1114208907 | Building Opportunities for Self Sufficiency | Community/Behavioral Health | 730 #8 Bartlett Ave, Hayward, CA 94544 | 2011-09-07 |
| Find all providers in zip 94544 | ||||
| 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 |
|---|---|---|---|---|
| 1972779338 | Kavitha Rajaram | Pediatrics | 21297 Foothill Blvd Ste 100, Hayward, CA 94541-1554 | 2008-05-06 |
| 1801933668 | Castro Valley Pediatrics | Pediatrics | 22290 Foothill Blvd., Ste. 1, Hayward, CA 94541 | 2007-01-31 |
| 1194827980 | Jerrilyn Johnston | Pediatrics | 22290 Foothill Blvd #1, Hayward, CA 94541 | 2006-09-02 |
| 1326055963 | Kasthuri Rajaram | Pediatrics | 21297 Foothill Blvd #100, Hayward, CA 94541-1552 | 2006-08-02 |
| 1932580115 | Rebecca Ives | Pediatrics | 27303 Sleepy Hollow Ave S, Hayward, CA 94545 | 2015-06-14 |
| 1417343443 | Rebecca Zabel | Pediatrics | 27303 Sleepy Hollow Ave S, Hayward, CA 94545-4203 | 2015-04-07 |
| 1356611370 | Hadia Siddiqui | Pediatrics | 27303 Sleepy Hollow Avenue, Hayward, CA 94545-4203 | 2012-01-06 |
| 1346540200 | Neha Yadav | Pediatrics | 27303 Sleepy Hollow Avenue, Hayward, CA 94545-4203 | 2010-10-26 |
| 1558502625 | Hayward Pediatric Medical Clinic | Pediatrics | 21297 Foothill Blvd Ste 100, Hayward, CA 94541-1554 | 2009-03-18 |
| 1790960128 | James Lue | Pediatrics | 27303 Sleepy Hollow Avenue, Hayward, CA 94545-4203 | 2008-01-03 |
| Find all providers in HAYWARD | ||||
Please comment or provide details below to improve the information on SOUTH COUNTY PEDIATRIC MEDICAL GROUP.
| 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.