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Organization
SOUTH COUNTY PEDIATRIC MEDICAL GROUP
Active
Organization
SOUTH COUNTY PEDIATRIC MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOMAS A MAGANA M.D. (DIRECTOR)
(510) 782-4470
Entity
Organization
Contact information
Practice address
680 W TENNYSON RD, HAYWARD, CA 94544-5236
(510) 782-4470
Mailing address
5528 PACHECO BLVD, STE A, PACHECO, CA 94553-5126
(925) 363-8170
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0102930
—
CA
Enumeration date
02/16/2007
Last updated
06/30/2008
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