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ADVANCED PEDIATRIC MEDICAL GROUP INC
NPI 1558459180
Clinic/Center - Primary Care in San Diego, CA

Active since October 10, 2006CLIA 05D0918752 · Waiver
5222 BALBOA AVE, SUITE 42, SAN DIEGO, CA 92117(858) 268-0702(858) 268-0374 Get Directions Write a Review

NPPES record last updated: February 25, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Advanced Pediatric Medical Group Inc NPPES

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

ADVANCED PEDIATRIC MEDICAL GROUP INC (NPI 1558459180) is a healthcare organization registered as a primary care in San Diego, California and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through August 19, 2026 and lists Jay Jalal Sadrieh, President And Officer, as its authorized official.

NPPES Registry Identity

NPI1558459180
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameADVANCED PEDIATRIC MEDICAL GROUP INC
Location Address5222 BALBOA AVE, SUITE 42San Diego, CA 92117-6904
Mailing Address5222 Balboa Ave, Suite 42San Diego, CA 92117-6991 · (858) 268-0702 · Fax (858) 268-0374
Phone(858) 268-0702
Fax(858) 268-0374
Organization SubpartNo
Authorized OfficialJay Jalal SadriehPresident And Officer · (858) 268-0702
Enumeration DateOctober 10, 2006
Last NPPES UpdateFebruary 25, 2013
✔ NPI 1558459180 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in CA · A46462
5222 BALBOA AVE, San Diego, CA 92117
Open in Google Maps ↗

Other Identifiers 1

MedicaidGR0071320CA

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 05D0918752

Advance Pediatric Medical Group · San Diego, CA
Active · expires Aug 19, 2026
CLIA Number05D0918752
Laboratory TypePhysician Office
Certificate Effective DateAugust 20, 2024
Certificate Expiration DateAugust 19, 2026
Laboratory DirectorJay J. Sadrieh
Laboratory Phone(858) 268-0702
Laboratory LocationAdvance Pediatric Medical Group5222 Balboa Ave #42, San Diego, CA 92117
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 14

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

DR. LESLIE ALISON MARK M.D.
Dermatology
5222 BALBOA AVE, SIXTH FLOOR
SAN DIEGO, CA 92117
San Diego County (858) 292-0204
DR. BARBARA ELAINE MARTIN M.D.
Dermatology
5222 BALBOA AVE, FIFTH FLOOR
SAN DIEGO, CA 92117
San Diego County (858) 292-7928
DR. KENNETH GARY GROSS M.D.
Dermatology
5222 BALBOA AVE, SIXTH FLOOR
SAN DIEGO, CA 92117
San Diego County (858) 292-5101
DR. MAHINDOKHT MARY RAISZADEH M.D.
Legal Medicine
5222 BALBOA AVE, STE 45
SAN DIEGO, CA 92117
San Diego County (858) 616-6430
ERICA DAWN STARK L.AC.
Acupuncturist
5222 BALBOA AVE, SUITE 43
SAN DIEGO, CA 92117
San Diego County (858) 568-2189
DR. WALTER HAROLD JOLLEY D.P.M.
Podiatrist (Foot & Ankle Surgery)
5222 BALBOA AVE, SUITE 52
SAN DIEGO, CA 92117
San Diego County (858) 560-0390
RTY PHARMACEUTICAL INC
Pharmacy (Specialty Pharmacy)
5222 BALBOA AVE
SAN DIEGO, CA 92117
San Diego County (858) 278-0111
DR. DALE EDWARD MARTIN M.D.
Dermatology
5222 BALBOA AVE, SIXTH FLOOR
SAN DIEGO, CA 92117
San Diego County (858) 292-5101

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 Advanced Pediatric Medical Group Inc's NPI number?

The NPI number for Advanced Pediatric Medical Group Inc is 1558459180. It was assigned to this organization in the NPPES registry on October 10, 2006.

Where is Advanced Pediatric Medical Group Inc located?

Advanced Pediatric Medical Group Inc is located at 5222 Balboa Ave Suite 42, San Diego, CA 92117. The listed phone number is (858) 268-0702.

What is Advanced Pediatric Medical Group Inc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Advanced Pediatric Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0918752) is associated with this NPI, valid through August 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Advanced Pediatric Medical Group Inc was last updated on February 25, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.