Provider Demographics
NPI:1740566694
Name:MIGHTY KIDZ PEDIATRICS
Entity Type:Organization
Organization Name:MIGHTY KIDZ PEDIATRICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:SANTIAGO
Authorized Official - Last Name:CARIGMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-403-0400
Mailing Address - Street 1:18821 PIONEER BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90701-5667
Mailing Address - Country:US
Mailing Address - Phone:562-403-0400
Mailing Address - Fax:562-403-0404
Practice Address - Street 1:18821 PIONEER BLVD STE D
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90701-5667
Practice Address - Country:US
Practice Address - Phone:562-403-0400
Practice Address - Fax:562-403-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA108171208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty