CENTRAL CALIFORNIA FACULTY MEDICAL GROUP INC. NPI 1669507752

NPI Information

NPI: 1669507752
Provider Name: CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

Address:
1247 E ALLUVIAL AVE
SUITE 101
FRESNO, CA
ZIP 93720
Phone: (559) 431-6226
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CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC. is a vascular surgery surgery in Fresno, CA. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC. NPI is 1669507752. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1247 E ALLUVIAL AVE
SUITE 101
FRESNO, CA
ZIP 93720-686
Phone: (559) 431-6226
Fax: (559) 440-9005

The provider's authorized official is Karl P Van Gundy .
The authorized official title is President and has the following contact phone number (559) 453-5200.

The enumeration date for this NPI number is 2/22/2007 and was last updated on 11/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist				No
2	2086S0129X	Surgery	Vascular Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ZZZ00877Z	MEDICARE PIN
2	DC4679	OTHER	CALIFORNIA	RAILROAD MEDICARE
3	GR0014818	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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