Provider Demographics
NPI:1528235355
Name:STRONGKIDS MEDICAL GROUP INC
Entity type:Organization
Organization Name:STRONGKIDS MEDICAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-915-4656
Mailing Address - Street 1:P.O. BOX 8500
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92658-8500
Mailing Address - Country:US
Mailing Address - Phone:714-535-3330
Mailing Address - Fax:714-535-4332
Practice Address - Street 1:1491 E LA PALMA AVE
Practice Address - Street 2:STE B
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-1564
Practice Address - Country:US
Practice Address - Phone:714-535-3330
Practice Address - Fax:714-535-4332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABUS2006-04344208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A446640Medicaid
CAGR0105311Medicaid
CA00A213320Medicaid
CA00C350690Medicaid
CA00A378880Medicaid
CA00A943300Medicaid
CA00G268130Medicaid
CA00PA142210Medicaid
CA00PA177430Medicaid
CA00PA183200Medicaid