SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF SURGERY NPI 1851574735

NPI Information

NPI: 1851574735
Provider Name: SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF SURGERY
Classification: Surgery - 2086S0120X
Entity Type: Organization

Specialization: Pediatric Surgery

Address:
9300 VALLEY CHILDRENS PL
MADERA, CA
ZIP 93636
Phone: (559) 353-7290
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SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF SURGERY is a pediatric surgery surgery in Madera, CA. The provider is a surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF SURGERY NPI is 1851574735. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9300 VALLEY CHILDRENS PL
MADERA, CA
ZIP 93636-761
Phone: (559) 353-7290
Fax: (559) 353-7286

The provider's authorized official is Ralph P. Diaz .
The authorized official title is President And Medical Director and has the following contact phone number (559) 353-5700.

The enumeration date for this NPI number is 12/13/2007 and was last updated on 12/13/2007.

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	208600000X	Surgery			CALIFORNIA	No
2	2086S0120X	Surgery	Pediatric Surgery		CALIFORNIA	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	GR007868M	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: 11/14/2023

NPI Synchronization or Removal

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