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Organization
PEDIATRIC MEDICAL ASSOCIATES OF TRI-CITY, INC.
Active
Organization
PEDIATRIC MEDICAL ASSOCIATES OF TRI-CITY, INC.
Active
Other names
Pediatric Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNINE EDWARDS (ADMINISTRATOR)
(760) 945-3434
Entity
Organization
Contact information
Practice address
2067 W VISTA WAY, SUITE 180, VISTA, CA 92083-6031
(760) 945-3434
(760) 945-6761
Mailing address
2067 W VISTA WAY, SUITE 180, VISTA, CA 92083-6031
(760) 945-3434
(760) 945-6761
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0092060
—
CA
Enumeration date
08/14/2006
Last updated
08/22/2020
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