Healthcare Provider Details

I. General information

NPI: 1861703027
Provider Name (Legal Business Name): THE PEDIATRIC GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 N. ROBERTSON BLVD. SUITE 404
BEVERLY HILLS CA
90211-1789
US

IV. Provider business mailing address

250 N. ROBERTSON BLVD. SUITE 404
BEVERLY HILLS CA
90211-1789
US

V. Phone/Fax

Practice location:
  • Phone: 310-273-9533
  • Fax: 310-273-8358
Mailing address:
  • Phone: 310-273-9533
  • Fax: 310-273-8358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA85596
License Number StateCA

VIII. Authorized Official

Name: DR. RACHEL JOANNE KRAMER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 310-273-9533