Healthcare Provider Details

I. General information

NPI: 1548462310
Provider Name (Legal Business Name): NORTH COUNTY PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 VINE ST
PASO ROBLES CA
93446-2597
US

IV. Provider business mailing address

1108 VINE ST
PASO ROBLES CA
93446-2597
US

V. Phone/Fax

Practice location:
  • Phone: 808-523-9422
  • Fax:
Mailing address:
  • Phone: 808-523-9422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG23915
License Number StateCA

VIII. Authorized Official

Name: DR. RONALD FIELD
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 805-239-4222