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General NPI Number Information
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NPI Number | 1205911286
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Entity Type | Organization
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Legal Business Name | COMMUNITY PEDIATRIC MEDICAL GROUP INC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1250 LA VENTA DRIVE #103
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-495-0841
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Fax | 805-497-6912
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Provider Business Mailing Address
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Address Line | 1250 LA VENTA DRIVE #103
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-495-0841
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Fax | 805-497-6912
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. DAVID SCHERR
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Credential | MD
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Telephone | 805-495-0841
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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