| Internal Medicine Specialists Medical Group, Inc. | |
|
1515 E Alluvial Ave Suite 101 Fresno CA 93720-3832 | |
| (559) 435-0339 | |
| (559) 435-0853 |
| Full Name | Internal Medicine Specialists Medical Group, Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1515 E Alluvial Ave, Fresno, California |
| Authorized Official Name and Position | Mythe Laramie (CO-OWNER) |
| Authorized Official Contact | 5594350339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internal Medicine Specialists Medical Group, Inc. 1515 E Alluvial Ave Suite 101 Fresno CA 93720-3832 Ph: (559) 435-0339 | Internal Medicine Specialists Medical Group, Inc. 1515 E Alluvial Ave Suite 101 Fresno CA 93720-3832 Ph: (559) 435-0339 |
| NPI Number | 1366783268 |
|---|---|
| Provider Enumeration Date | 03/03/2013 |
| Last Update Date | 06/06/2023 |
| Medicare PECOS PAC ID | 5092953323 |
|---|---|
| Medicare Enrollment ID | O20130529000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366783268 | NPI | - | NPPES |
| G80217 | Other | CA | INTERNAL MEDICINE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | G59244 (California) | Primary |
| 207R00000X | Internal Medicine | G38222 (California) | Secondary |
| Provider Name | Mythe Laramie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801907399 PECOS PAC ID: 1850328345 Enrollment ID: I20050726001202 |
| Provider Name | Thomas E Griffin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023038031 PECOS PAC ID: 4981505690 Enrollment ID: I20080702000196 |
| Provider Name | Steven H Chooljian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245250232 PECOS PAC ID: 1355432022 Enrollment ID: I20080715000341 |
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