| Internal Medicine And Pediatrics Medical Group | |
|
568 E Herndon Ave Suite 101 Fresno CA 93720-2989 | |
| (559) 224-7990 | |
| (559) 224-5617 |
| Full Name | Internal Medicine And Pediatrics Medical Group |
|---|---|
| Speciality | Pediatrics |
| Location | 568 E Herndon Ave, Fresno, California |
| Authorized Official Name and Position | Nagaratnamma Madireddy (MEDICAL DIRECTOR) |
| Authorized Official Contact | 5592247990 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine And Pediatrics Medical Group 568 E Herndon Ave Ste 101 Fresno CA 93720-2989 Ph: (559) 224-7990 | Internal Medicine And Pediatrics Medical Group 568 E Herndon Ave Suite 101 Fresno CA 93720-2989 Ph: (559) 224-7990 |
| NPI Number | 1063409167 |
|---|---|
| Provider Enumeration Date | 10/04/2005 |
| Last Update Date | 06/13/2019 |
| Medicare PECOS PAC ID | 3577500131 |
|---|---|
| Medicare Enrollment ID | O20050414000713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063409167 | NPI | - | NPPES |
| GR0077500 | Other | CA | CHDP |
| GR0077500 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A51491 (California) | Secondary |
| 207R00000X | Internal Medicine | A51494 (California) | Secondary |
| 208000000X | Pediatrics | A51491 (California) | Primary |
| Provider Name | Madhava Reddy Narala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447246699 PECOS PAC ID: 9133216468 Enrollment ID: I20071101000729 |
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