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MY PEDIATRIC HOME
NPI 1619622636
Pediatrics in Redlands, CA

Active since February 17, 2022CLIA 05D2274852 · Waiver
414 TENNESSEE ST STE K1, REDLANDS, CA 92373(909) 531-4427(909) 288-4731 Get Directions Write a Review

NPPES record last updated: October 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 3, 2024, Feb 17, 2022 (2 updates tracked since 2022).

About My Pediatric Home NPPES

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

MY PEDIATRIC HOME (NPI 1619622636) is a healthcare organization registered as a pediatrics in Redlands, California and active in the NPI registry since February 2022. The organization holds a CLIA Waiver certificate valid through January 10, 2027 and lists Jennifer Cobanov, Ceo/medical Director, as its authorized official.

NPPES Registry Identity

NPI1619622636
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameJENNIFER COBANOV, MD PROFESSIONAL CORPORATION
Location Address414 TENNESSEE ST STE K1Redlands, CA 92373-8152
Mailing AddressPo Box 902Loma Linda, CA 92354-0902 · (909) 647-8783
Phone(909) 531-4427
Fax(909) 288-4731
Organization SubpartNo
Authorized OfficialJennifer CobanovCeo/medical Director · (909) 647-8783
Enumeration DateFebruary 17, 2022
Last NPPES UpdateOctober 3, 20242 updates tracked since enumeration
NPPES CertifiedOctober 3, 2024
✔ NPI 1619622636 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.
414 TENNESSEE ST STE K1, Redlands, CA 92373
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Other Names 1

Doing Business AsMy Pediatric Home

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 05D2274852

My Pediatric Home · Redlands, CA
Active · expires Jan 10, 2027
CLIA Number05D2274852
Laboratory TypePhysician Office
Certificate Effective DateJanuary 11, 2025
Certificate Expiration DateJanuary 10, 2027
Laboratory DirectorJennifer Cobanov
Laboratory Phone(909) 531-4427
Laboratory LocationMy Pediatric Home414 Tennessee St Ste K1, Redlands, CA 92373
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 4

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

SMILE BRIGHT DENTAL CORPORATION
Dentist (Dental Public Health)
414 TENNESSEE ST STE K1
REDLANDS, CA 92373
San Bernardino County (909) 798-4000
DR. JENNIFER COBANOV M.D.
Pediatrics
414 TENNESSEE ST STE K1
REDLANDS, CA 92373
San Bernardino County (909) 531-4427
FRANCISCO D. FORES
Dentist (General Practice)
414 TENNESSEE ST STE K1
REDLANDS, CA 92373
San Bernardino County (562) 414-4222
FRANCISCO D FORES DMD
Dentist (General Practice)
414 TENNESSEE ST STE K1
REDLANDS, CA 92373
San Bernardino County (661) 917-0507

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 Jennifer Cobanov, MD Professional Corporation's NPI number?

The NPI number for Jennifer Cobanov, MD Professional Corporation is 1619622636. It was assigned to this organization in the NPPES registry on February 17, 2022. The provider is doing business as My Pediatric Home.

Where is Jennifer Cobanov, MD Professional Corporation located?

Jennifer Cobanov, MD Professional Corporation is located at 414 Tennessee St Ste K1, Redlands, CA 92373. The listed phone number is (909) 531-4427.

What is Jennifer Cobanov, MD Professional Corporation's specialty?

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

Does Jennifer Cobanov, MD Professional Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2274852) is associated with this NPI, valid through January 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jennifer Cobanov, MD Professional Corporation was last updated on October 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months 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.