| Central California Faculty Medical Group, Inc. | |
|
2625 E Divisadero St Fresno CA 93721-1431 | |
| (559) 453-5200 | |
| (559) 443-2681 |
| Full Name | Central California Faculty Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2625 E Divisadero St, Fresno, California |
| Authorized Official Name and Position | Randall Stern (PRESIDENT) |
| Authorized Official Contact | 5594432682 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Central California Faculty Medical Group, Inc. 2625 E Divisadero St Fresno CA 93721-1431 Ph: (559) 453-5200 | Central California Faculty Medical Group, Inc. 2625 E Divisadero St Fresno CA 93721-1431 Ph: (559) 453-5200 |
| NPI Number | 1992742852 |
|---|---|
| Provider Enumeration Date | 06/01/2006 |
| Last Update Date | 10/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992742852 | NPI | - | NPPES |
| GRE001360 | Medicaid | CA | |
| ZZZ83317Z | Medicaid | CA | |
| GPS000540 | Medicaid | CA | |
| GR0077241 | Medicaid | CA | |
| GR0077244 | Medicaid | CA |
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