Healthcare Provider Details

I. General information

NPI: 1457608580
Provider Name (Legal Business Name): JUST 4 KIDS PEDIATRICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2012
Last Update Date: 10/12/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1433 W MERCED AVE STE 103
WEST COVINA CA
91790
US

IV. Provider business mailing address

1433 W MERCED AVE STE 103
WEST COVINA CA
91790
US

V. Phone/Fax

Practice location:
  • Phone: 626-502-1214
  • Fax: 626-502-1346
Mailing address:
  • Phone: 626-502-1214
  • Fax: 626-502-1346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA71264
License Number StateCA

VIII. Authorized Official

Name: AARTI KULSHRESTHA
Title or Position: OWNER/ PRESIDENT
Credential: M.D.
Phone: 626-502-1214