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CENTRAL CALIFORNIA FACULTY MEDICAL GROUP INC. NPI 1205971595


NPI Information

NPI: 1205971595
Provider Name: CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 05D0717022

Address:
7415 N CEDAR AVE
SUITE 102
FRESNO, CA
ZIP 93720
Phone: (559) 435-6600
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CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC. is an internal medicine in Fresno, 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. CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC. NPI is 1205971595. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

7415 N CEDAR AVE
SUITE 102
FRESNO, CA
ZIP 93720-834
Phone: (559) 435-6600
Fax: (559) 435-6622

The provider's authorized official is Karl P Van Gundy .
The authorized official title is President and has the following contact phone number (559) 443-2682.

The CLIA number assigned to this NPI record is 05D0717022 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 2/27/2015.


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
1207T00000XNeurological SurgeryNo
2207X00000XOrthopaedic SurgeryNo
3208600000XSurgeryNo
4207RP1001XInternal MedicinePulmonary DiseaseNo
5207ND0900XDermatologyDermatopathologyNo
6207N00000XDermatologyNo
7207ND0101XDermatologyMOHS-Micrographic SurgeryNo
8207NS0135XDermatologyProcedural DermatologyNo
9207R00000XInternal MedicineYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GR0077240MEDICAIDCALIFORNIA
2GR0077242MEDICAIDCALIFORNIA
3ZZZ97421ZMEDICARE PIN
4ZZZ02627ZMEDICARE PIN
5ZZZ28490ZMEDICARE PIN
6GR0014812MEDICAIDCALIFORNIA
7GR0077243MEDICAIDCALIFORNIA
8ZZZ13601ZMEDICARE PIN
9GR0014819MEDICAIDCALIFORNIA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.