OrganizationActive
Kids Doc of Southern California Medical Group, Inc.
NPI 1013966670 · Pediatrics Physician · Mission Viejo, CA
Provider details
- NPI number
- 1013966670
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Mary Ann Wilkinson, Treasurer(949) 951-5437
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
27800 Medical Center Rd Suite 204
Mission Viejo, CA 92691
Phone: (949) 682-4750
Fax: (949) 682-4751
Street-level locationGet directions
Mailing address
27800 Medical Center Rd Suite 204
Mission Viejo, CA 92691
Registry dates
- Enumerated
- 2006-05-09
- Last updated
- 2016-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.