Provider Demographics
NPI:1790929750
Name:ALMADEN PEDIATRICS, INC
Entity Type:Organization
Organization Name:ALMADEN PEDIATRICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RECORD-CONTINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-268-1122
Mailing Address - Street 1:6489 CAMDEN AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95120-2849
Mailing Address - Country:US
Mailing Address - Phone:408-268-1122
Mailing Address - Fax:408-268-5215
Practice Address - Street 1:6489 CAMDEN AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-2849
Practice Address - Country:US
Practice Address - Phone:408-268-1122
Practice Address - Fax:408-268-5215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2009-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62447208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA62447OtherLICENSE NUMBER