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Organization
PEDIATRIC PARTNERS MEDICAL PROFESSIONAL CORPORATION
Active
Organization
PEDIATRIC PARTNERS MEDICAL PROFESSIONAL CORPORATION
Active
Parent organization
PEDIATRIC PARTNERS MEDICAL PROFESSIONAL CORPORATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
PEDIATRIC PARTNERS MEDICAL PROFESSIONAL CORPORATION
Authorized official
THOMAS P MOHR M.D. (CHIEF EXECUTIVE OFFICER)
(951) 252-8588
Entity
Organization
Contact information
Practice address
26900 NEWPORT RD, SUITE 107, MENIFEE, CA 92584-9222
(951) 301-5380
(951) 301-5390
Mailing address
27699 JEFFERSON AVE, SUITE 300, TEMECULA, CA 92590-2661
(951) 252-8588
(951) 252-8589
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0088823
MEDI-CAL
CA
Enumeration date
10/11/2006
Last updated
03/29/2017
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