CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG – NPI #1144387614
Surgery

A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.

CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG is a surgeon located in SAN DIEGO, CA. NPPES has assigned the NPI number 1144387614 to CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG on January 03, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The former legal business name for this organization is CHILDREN'S ASSOCIATED MEDICAL GROUP. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2086S0120X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Pediatric Surgery

The NPI profile was previously updated about 18 years ago on Apr 22, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG below.

NPI Profile for
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG

NPI Number
1144387614
Enumeration Date

(more than 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG
Former Legal Business Name: CHILDREN'S ASSOCIATED MEDICAL GROUP
Primary location
8010 FROST ST
SUITE 414
SAN DIEGO, CA 92123-2778
Phone: (858) 966-7711 Fax:
Mailing address
3860 CALLE FORTUNADA
SUITE 210
SAN DIEGO, CA 92123-4800
Phone: (858) 309-6303 Fax: (858) 309-6301
Organization Subpart
Yes - CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG is subpart of another organization.
Authorized Official
HERBERT KIMMONS
PRESIDENT
Phone: (858) 966-8567
Updated
Identifiers

Identifiers for CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF SURG

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDCAGR0083550
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0120X
- Surgery / Pediatric Surgery (Primary)
208600000X
- Surgery

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.