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Organization
KIDIATRICS MEDICAL GROUP, INC.
Active
Organization
KIDIATRICS MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIVEDITA N MORE M.D. (PHYSICAN/PRESIDENT)
(949) 766-5001
Entity
Organization
Contact information
Practice address
22032 EL PASEO, #160, RANCHO SANTA MARGARITA, CA 92688-3947
(949) 766-5001
(949) 766-5118
Mailing address
22032 EL PASEO, #160, RANCHO SANTA MARGARITA, CA 92688-3947
(949) 766-5001
(949) 766-5118
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A069104
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A691040
CALOPTIMA
CA
05
—
00A691040
—
CA
01
—
ZZZ01773Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
01/09/2008
Last updated
01/09/2008
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