Provider Demographics
NPI:1982987095
Name:APEX PEDIATRICS INC
Entity Type:Organization
Organization Name:APEX PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:WILDISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:951-378-3605
Mailing Address - Street 1:399 E HIGHLAND AVE STE 329
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-3861
Mailing Address - Country:US
Mailing Address - Phone:909-886-5200
Mailing Address - Fax:909-886-0333
Practice Address - Street 1:399 E HIGHLAND AVE STE 329
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-3861
Practice Address - Country:US
Practice Address - Phone:909-886-5200
Practice Address - Fax:909-886-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-25
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A4252620208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty