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WALNUT CREEK PEDIATRIC MEDICAL GRP
NPI 1275550030
Pediatrics in Walnut Creek, CA

Active since July 17, 2006CLIA 05D0708615 · Waiver
1822 SAN MIGUEL DRIVE, WALNUT CREEK, CA 94596(925) 945-3580(925) 934-0471 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: September 27, 2026.

About Walnut Creek Pediatric Medical Grp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WALNUT CREEK PEDIATRIC MEDICAL GRP (NPI 1275550030) is a healthcare organization registered as a pediatrics in Walnut Creek, California and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists Montgomery Lawton Kong, Physician, as its authorized official.

NPPES Registry Identity

NPI1275550030
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameWALNUT CREEK PEDIATRIC MEDICAL GRP
Location Address1822 SAN MIGUEL DRIVEWalnut Creek, CA 94596
Mailing Address1822 San Miguel DriveWalnut Creek, CA 94596 · (925) 945-3580 · Fax (925) 934-0471
Phone(925) 945-3580
Fax(925) 934-0471
Organization SubpartNo
Authorized OfficialMontgomery Lawton KongPhysician · (925) 945-3580
Enumeration DateJuly 17, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1275550030 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1822 SAN MIGUEL DRIVE, Walnut Creek, CA 94596
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0708615

Walnut Creek Pediatric Medical Grp Inc · Walnut Creek, CA
Active · expires Aug 31, 2028
CLIA Number05D0708615
Laboratory TypePhysician Office
Certificate Effective DateSeptember 1, 2026
Certificate Expiration DateAugust 31, 2028
Laboratory DirectorCristina Chualim
Laboratory Phone(925) 945-3580
Laboratory LocationWalnut Creek Pediatric Medical Grp Inc1822 San Miguel Drive, Walnut Creek, CA 94596
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TOBY LUSTIG MD
Pediatrics
1822 SAN MIGUEL DRIVE
WALNUT CREEK, CA 94596
Contra Costa County (925) 945-3850

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Walnut Creek Pediatric Medical Grp's NPI number?

The NPI number for Walnut Creek Pediatric Medical Grp is 1275550030. It was assigned to this organization in the NPPES registry on July 17, 2006.

Where is Walnut Creek Pediatric Medical Grp located?

Walnut Creek Pediatric Medical Grp is located at 1822 San Miguel Drive, Walnut Creek, CA 94596. The listed phone number is (925) 945-3580.

What is Walnut Creek Pediatric Medical Grp's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Walnut Creek Pediatric Medical Grp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0708615) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walnut Creek Pediatric Medical Grp was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.