Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blue Shield Promise Health Plan

Organization Pediatrics Physician · NPI 1134880818

Blue Shield Promise Health Plan is a Pediatrics Physician in Palmdale, California. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
4

Practice location Address checks out

38440 5th St W
Palmdale, CA 93551
Phone: (661) 575-2725
Fax: (661) 273-2139
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Pediatrics Physician Taxonomy 208000000X
Pain Medicine Physician Taxonomy 208VP0000X
Primary Care Nurse Practitioner Taxonomy 363LP2300X

Record details

NPI number1134880818
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kristen Cerf — President & Ceo Blue Shield Ca Prom · (510) 607-4376
NPI enumeratedJanuary 5, 2022
Last updated in NPPESJanuary 5, 2022
Certification dateJanuary 5, 2022
Mailing address38440 5th Street West, Palmdale, CA 93551

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