Provider Demographics
NPI:1497700322
Name:CFL CHILDREN'S MEDICAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:CFL CHILDREN'S MEDICAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NARCISO
Authorized Official - Middle Name:THAD
Authorized Official - Last Name:PADUA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-947-2697
Mailing Address - Street 1:2039 FOREST AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4817
Mailing Address - Country:US
Mailing Address - Phone:408-297-5959
Mailing Address - Fax:408-297-5970
Practice Address - Street 1:2039 FOREST AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4817
Practice Address - Country:US
Practice Address - Phone:408-297-5959
Practice Address - Fax:408-297-5970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45172208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0060090Medicaid
CAGR0060091Medicaid
CAZZZ01893ZOtherBLUE SHIELD GROUP NUMBER