CLOVIS PEDIATRIC GROUP (NPI# 1538574660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538574660 |
| Entity Type | Organization |
| Organization Name | CLOVIS PEDIATRIC GROUP |
| Practice Address |
729 N Medical Center Dr W 201 Clovis CA 93611-6879 |
| Mailing Address |
319 W Fallbrook Ave Clovis CA 93611-7107 |
| Practice Telephone | 5599084852 |
| Practice Fax Number | 5593545214 |
| Mailing Telephone | 5599084852 |
| Mailing Fax Number | 5593545214 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |
| Authorized Official Name | DR. AMAR SIDDIQUE (PRESIDENT) |
| Authorized Official Telephone | 5599084852 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
A93835 | CA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | A93835 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A938350 | 05 |
| Street Address |
729 N MEDICAL CENTER DR W 201 |
| City | CLOVIS |
| State | CA |
| Zip Code | 93611-6879 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881762896 | Eric L Pagenkopf | Orthopaedic Surgery | 729 N Medical Center Dr W, Suite 111, Clovis, CA 93611-6879 | 2006-11-30 |
| 1841727658 | Sirvard M Kaptryan | Nurse Practitioner | 729 N Medical Center Dr W, 101, Clovis, CA 93611-6879 | 2017-05-11 |
| 1598155202 | Elizabeth Aurea May | Physician Assistant | 729 N Medical Center Dr W, Suite 111, Clovis, CA 93611-6879 | 2015-02-02 |
| 1528468501 | Tawne Fishback | Nurse Practitioner | 729 N Medical Center Dr W, Clovis, CA 93611-6879 | 2014-08-27 |
| 1740613041 | Joshua Paul Lazarus | Physician Assistant | 729 N Medical Center Dr W, Clovis, CA 93611-6879 | 2013-08-10 |
| 1184885519 | John Edward Tidwell | Orthopaedic Surgery | 729 N Medical Center Dr W, Suite 111, Clovis, CA 93611-6879 | 2008-06-18 |
| 1326237629 | Christine Marie Card | Nurse Practitioner | 729 N Medical Center Dr W, Suite 205, Clovis, CA 93611-6879 | 2007-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033773122 | Mao Thao | Pharmacist | 2133 Shaw Avenue, Clovis, CA 93611 | 2019-04-24 |
| 1326506098 | Lauren Moriah Horsley | Speech-Language Pathologist | 650 W. Alluvial Ave., Clovis, CA 93611 | 2019-03-12 |
| 1780171223 | Alamos Care | Skilled Nursing Facility | 2193 Alamos Ave, Clovis, CA 93611 | 2018-04-19 |
| 1346612215 | Aimee Rasch | Occupational Therapy Assistant | 650 West Alluvial Avenue, Clovis, CA 93611 | 2015-10-30 |
| 1356778302 | Jonathan Crosby | Physician Assistant | 729 N Medical Center Drive West Suite 101, Clovis, CA 93611 | 2013-10-07 |
| 1093142697 | Stacey Melissa Montes | Nurse Practitioner | 729 N Medical Ctr Dr West, Suite 205, Clovis, CA 93611 | 2013-09-27 |
| 1538594163 | Carly Bren Lepp | Physician Assistant | 2006 Shaw Avenue, Clovis, CA 93611 | 2013-09-13 |
| 1811246150 | Vishal Arya | Pharmacist | 2518 Austin Ave, Clovis, CA 93611 | 2012-08-31 |
| 1669757209 | Kiran V Atwal | Pharmacist | 1815 Herndon Ave--walgreens, Clovis, CA 93611 | 2011-10-14 |
| 1952615957 | Weight Away | Nutritionist | 1895 Herndon Ave, Suite 105, Clovis, CA 93611 | 2010-08-02 |
| Find all providers in zip 93611 | ||||
| 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 |
|---|---|---|---|---|
| 1629370903 | Parmala Kumari Bangar | Pediatrics | 180 W Shaw Ave, Clovis, CA 93612-3746 | 2010-11-18 |
| 1700195195 | Ian Ocrant | Pediatrics | 377 W Spruce Ave, 101, Clovis, CA 93611-3303 | 2010-10-01 |
| 1487982096 | William Thomas Vanbeever | Pediatrics | 275 West Herndon Ave, Clovis, CA 93612-1353 | 2009-11-20 |
| 1225116114 | John C. Kircher | Pediatrics | 7819 N Willow Ave, Clovis, CA 93611-8334 | 2006-11-01 |
| 1760599153 | Thien T Luu Md Pa | Pediatrics | 2000 W 21st, E-2, Clovis, NM 88101 | 2006-08-23 |
| 1417946195 | Salvatore La Fata | Pediatrics | 2020 Sheffield Dr, Clovis, NM 88101-4940 | 2005-10-17 |
| 1447860614 | Health-e Pediatrics | Pediatrics | 1865 Herndon Ave Ste K616, Clovis, CA 93611-6163 | 2020-08-03 |
| 1912369927 | Jesse Adam Alifano | Pediatrics | 275 W Herndon Ave, Clovis, CA 93612 | 2016-03-28 |
| 1437403813 | Basil A Anaele | Pediatrics | 1521 W 13th St, Clovis, NM 88101-5568 | 2012-11-06 |
| 1679830368 | Nancy Hua | Pediatrics | 726 N Medical Center Dr E Ste 209, Clovis, CA 93611-6886 | 2012-04-18 |
| Find all providers in CLOVIS | ||||
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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.