Provider Demographics
NPI:1982025292
Name:FELICITY PEDIATRICS, A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:FELICITY PEDIATRICS, A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:USHA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLAMDAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-368-8670
Mailing Address - Street 1:2400 BALFOUR RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-4945
Mailing Address - Country:US
Mailing Address - Phone:925-684-7443
Mailing Address - Fax:925-684-4591
Practice Address - Street 1:2400 BALFOUR RD
Practice Address - Street 2:SUITE 302
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-4945
Practice Address - Country:US
Practice Address - Phone:925-684-7443
Practice Address - Fax:925-684-4591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-04
Last Update Date:2014-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care