Provider Demographics
NPI:1487032587
Name:PEDIATRIC PHYSICIANS GROUP, INC.
Entity type:Organization
Organization Name:PEDIATRIC PHYSICIANS GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRASCHETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:760-777-7300
Mailing Address - Street 1:PO BOX 5067
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92248-5067
Mailing Address - Country:US
Mailing Address - Phone:760-777-7300
Mailing Address - Fax:760-777-7707
Practice Address - Street 1:79-180 CORPORATE CENTRE DR.
Practice Address - Street 2:STE. 103
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253
Practice Address - Country:US
Practice Address - Phone:760-777-7300
Practice Address - Fax:760-777-7707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-11
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty