| Cmg Medical Group, Inc. | |
|
665 Main St Suite B Morro Bay CA 93442-2269 | |
| (805) 771-8365 | |
| (805) 771-9242 |
| Full Name | Cmg Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 665 Main St, Morro Bay, California |
| Authorized Official Name and Position | Steven B. Goodman (PRESIDENT) |
| Authorized Official Contact | 8057718365 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cmg Medical Group, Inc. 1555 Higuera St San Luis Obispo CA 93401-2917 Ph: (805) 543-4043 | Cmg Medical Group, Inc. 665 Main St Suite B Morro Bay CA 93442-2269 Ph: (805) 771-8365 |
| NPI Number | 1649356908 |
|---|---|
| Provider Enumeration Date | 10/30/2006 |
| Last Update Date | 10/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649356908 | NPI | - | NPPES |
| ZZZ55765Z | Other | CA | BLUE SHIELD OF CA |
| GR0069892 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C1935201 (California) | Primary |
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