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Organization
PEDIATRIC CARE MEDICAL GROUP, INC.
Active
Organization
PEDIATRIC CARE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL Y QAQUNDAH M.D. (PRESIDENT)
(714) 842-1441
Entity
Organization
Contact information
Practice address
17822 BEACH BLVD, SUITE 278, HUNTINGTON BEACH, CA 92647-7101
(714) 842-1441
(714) 843-0394
Mailing address
17822 BEACH BLVD, SUITE 278, HUNTINGTON BEACH, CA 92647-7101
(714) 842-1441
(714) 843-0394
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A24153
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0025680
—
CA
Enumeration date
06/22/2006
Last updated
08/22/2020
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