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SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF UROLOGY NPI 1306029285


NPI Information

NPI: 1306029285
Provider Name: SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF UROLOGY
Classification: Urology - 2088P0231X
Entity Type: Organization

Specialization: Pediatric Urology

Address:
9300 VALLEY CHILDRENS PL
MB16
MADERA, CA
ZIP 93636
Phone: (559) 353-6195
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SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF UROLOGY is a pediatric urology urology in Madera, CA. The provider is surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele). SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF UROLOGY NPI is 1306029285. 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
MB16
MADERA, CA
ZIP 93636-761
Phone: (559) 353-6195
Fax: (559) 353-6196

The provider's authorized official is Ralph 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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12088P0231XUrologyPediatric UrologyCALIFORNIAYes

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
1GR007868LMEDICAIDCALIFORNIA

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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