MADERA FAMILY MEDICAL GROUP INC. NPI 1629172994

NPI Information

NPI: 1629172994
Provider Name: MADERA FAMILY MEDICAL GROUP INC.
Classification: Pediatrics - 208000000X
Entity Type: Organization
CLIA Number: 05D0913493
Address: 1111 W 4TH ST
MADERA, CA
ZIP 93637
Phone: (559) 673-3000

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NPI Details

MADERA FAMILY MEDICAL GROUP INC. is a pediatrics in Madera, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MADERA FAMILY MEDICAL GROUP INC. NPI is 1629172994. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1111 W 4TH ST
MADERA, CA
ZIP 93637-474
Phone: (559) 673-3000
Fax: (559) 662-2910

The provider's authorized official is Aftab A Naz .
The authorized official title is President and has the following contact phone number (559) 673-3000.

The CLIA number assigned to this NPI record is 05D0913493 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 9/8/2006 and was last updated on 3/23/2022.

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	Primary
1	207R00000X	Internal Medicine		No
2	2080P0206X	Pediatrics	Pediatric Gastroenterology	No
3	208000000X	Pediatrics		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	CH05081	OTHER	CALIFORNIA	CHDP LAB
2	LAB13493F	OTHER	CALIFORNIA	MCAID LAB#
3	GR0068140	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: 3/30/2025

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