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TABLE MOUNTAIN RANCHERIA MEDICAL CENTER NPI 1093983389


NPI Information

NPI: 1093983389
Provider Name: TABLE MOUNTAIN RANCHERIA MEDICAL CENTER
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 05D1013574

Address:
23638 SKY HARBOUR RD
FRIANT, CA
ZIP 93626
Phone: (559) 822-3785
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TABLE MOUNTAIN RANCHERIA MEDICAL CENTER is an internal medicine in Friant, CA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. TABLE MOUNTAIN RANCHERIA MEDICAL CENTER NPI is 1093983389. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

23638 SKY HARBOUR RD
FRIANT, CA
ZIP 93626-410
Phone: (559) 822-3785
Fax: (559) 822-2928

The provider's authorized official is Marilyn O Benck .
The authorized official title is Medical Director and has the following contact phone number (559) 822-3785.

The CLIA number assigned to this NPI record is 05D1013574 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/20/2008 and was last updated on 2/20/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineG42148CALIFORNIAYes

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

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