| Community Medical Providers Medical Group Inc | |
|
1180 E Shaw Ave Ste 125 Fresno CA 93710-7812 | |
| (559) 228-4200 | |
| (559) 224-3920 |
| Full Name | Community Medical Providers Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1180 E Shaw Ave, Fresno, California |
| Authorized Official Name and Position | Grant Nakamura (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5592285400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Providers Medical Group Inc Po Box 28900 Fresno CA 93729 Ph: (559) 228-4200 | Community Medical Providers Medical Group Inc 1180 E Shaw Ave Ste 125 Fresno CA 93710-7812 Ph: (559) 228-4200 |
| NPI Number | 1821075748 |
|---|---|
| Provider Enumeration Date | 12/30/2005 |
| Last Update Date | 10/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821075748 | NPI | - | NPPES |
| GR0068691 | Medicaid | CA | |
| GR0068696 | Medicaid | CA | |
| GR0068690 | Medicaid | CA | |
| GR0068695 | Medicaid | CA | |
| GR0068692 | Medicaid | CA | |
| GR0068693 | Medicaid | CA | |
| GR0068694 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G50552 (California) | Primary |
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