ADVANCED PEDIATRIC MEDICAL GROUP INC (NPI# 1558459180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558459180 |
| Entity Type | Organization |
| Organization Name | ADVANCED PEDIATRIC MEDICAL GROUP INC |
| Practice Address |
5222 Balboa Ave Suite 42 San Diego CA 92117-6904 |
| Mailing Address |
5222 Balboa Ave Suite 42 San Diego CA 92117-6991 |
| Practice Telephone | 8582680702 |
| Practice Fax Number | 8582680374 |
| Mailing Telephone | 8582680702 |
| Mailing Fax Number | 8582680374 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2013-02-25 |
| Authorized Official Name | DR. JAY JALAL SADRIEH (PRESIDENT AND OFFICER) |
| Authorized Official Telephone | 8582680702 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
A46462 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0071320 | 05 |
| Street Address |
5222 BALBOA AVE SUITE 42 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92117-6904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699772756 | Raymond C Heung | Internal Medicine | 5222 Balboa Ave, Ste 33, San Diego, CA 92117-6953 | 2005-07-05 |
| 1265851810 | Lindsay Lindsay Trottier | Acupuncturist | 5222 Balboa Ave, Suite 21, San Diego, CA 92117-6904 | 2014-04-10 |
| 1427499128 | Rty Pharmaceutical Inc | Pharmacy | 5222 Balboa Ave, San Diego, CA 92117-6904 | 2013-07-10 |
| 1215294244 | Erica Dawn Stark | Acupuncturist | 5222 Balboa Ave, Suite 43, San Diego, CA 92117-6904 | 2012-04-16 |
| 1447563275 | Jessica Davis | Nurse Practitioner | 5222 Balboa Ave, Suite 31, San Diego, CA 92117-6904 | 2010-07-21 |
| 1548441389 | Walter Jolley Dpm A Professional Corporation | Podiatrist | 5222 Balboa Ave, Suite 52, San Diego, CA 92117-6904 | 2007-11-20 |
| 1750570289 | Evelyn Jeehyun Kang | Chiropractor | 5222 Balboa Ave, Suite# 73, San Diego, CA 92117-6904 | 2007-10-22 |
| 1669699849 | Raymond Heung, M.d. | Clinical Medical Laboratory | 5222 Balboa Ave, Suite 33, San Diego, CA 92117-6904 | 2007-04-19 |
| 1538384573 | Mike Adams | Dentist | 5222 Balboa Ave, Suite 71, San Diego, CA 92117-6904 | 2007-04-16 |
| 1194898064 | Mahindokht Mary Raiszadeh | Legal Medicine | 5222 Balboa Ave, Ste 45, San Diego, CA 92117-6904 | 2006-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154956050 | Enbara Corporation | Dentist | 5189 Clairmont Mesa Blvd, San Diego, CA 92117 | 2020-03-11 |
| 1568956050 | Lourdes C Villagran | Case Manager/Care Coordinator | 4474 Charger Blvd, San Diego, CA 92117 | 2018-06-18 |
| 1750893509 | Dzendzel Family Chiropractic | Chiropractor | 3650 Clairemont Drive, Ste 2, San Diego, CA 92117 | 2017-11-02 |
| 1205355401 | Alan Ford | Counselor | 4150 Ute Dr., San Diego, CA 92117 | 2017-09-19 |
| 1780101238 | Allison Dawn Heeney | Occupational Therapist | 3386 Hopi Place, San Diego, CA 92117 | 2017-08-25 |
| 1275074379 | Rachel Gabrielle Packer | Counselor | 5252 Balboa Ave Ste 801, San Diego, CA 92117 | 2017-03-09 |
| 1316482995 | Lisa Graff-marsh, Inc. | Social Worker | 4985 Park Rim Dr., San Diego, CA 92117 | 2017-01-05 |
| 1417408949 | Markos and Markos 1 Inc | Private Vehicle | 4495 Clairemont Mesa Blvd, San Diego, CA 92117 | 2016-10-19 |
| 1801341813 | Huynh and Habashi Dental Corporation | Dentist | 2995 Clairemont Dr, Suite A, San Diego, CA 92117 | 2016-08-19 |
| 1184076077 | Tammy Monck | Optometrist | 3952 Clairemont Mesa Blvd Ste I, San Diego, CA 92117 | 2016-07-05 |
| Find all providers in zip 92117 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306463542 | Wellhaven Primary Care | Clinic/Center | 5555 Reservoir Dr Ste 303, San Diego, CA 92120-5181 | 2020-07-04 |
| 1205452349 | Klp Global | Clinic/Center | 3023 Bunker Hill St Ste 103, San Diego, CA 92109-5706 | 2020-06-24 |
| 1790247450 | Shawn Slayton, M.d. Inc. | Clinic/Center | 2700 Adams Ave Ste 209, San Diego, CA 92116-1367 | 2019-04-02 |
| 1073084729 | Bryan L Abramowitz Md Inc. | Clinic/Center | 4282 Genesee Ave Ste 302, San Diego, CA 92117-4985 | 2018-12-06 |
| 1699268458 | Monica Perlman Md Inc. | Clinic/Center | 555 W C St Ste 102, San Diego, CA 92101-8470 | 2018-06-07 |
| 1992200562 | Monica Perlman Md, Inc | Clinic/Center | 12925 El Camino Real Ste T25, San Diego, CA 92130-1891 | 2018-03-27 |
| 1396279113 | Dr Jaiswals Medical Center PC | Clinic/Center | 17424 Ashburton Rd, San Diego, CA 92128-3937 | 2017-04-18 |
| 1215381728 | Performance Sports and Family Medicine | Clinic/Center | 1277 Kettner Blvd Unit 311, San Diego, CA 92101-3381 | 2016-04-20 |
| 1093176331 | Stanford Employer Health Clinics | Clinic/Center | 10155 Pacific Heights Boulevard, San Diego, CA 92121 | 2016-03-15 |
| 1588024442 | Stanford Employer Health Clinics | Clinic/Center | 5535 Morehouse Dr Bldg S, Suite 270, San Diego, CA 92121-1710 | 2016-03-03 |
| Find all providers in SAN DIEGO | ||||
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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.