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SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF OTOLARYNGOLOGY NPI 1861673246


NPI Information

NPI: 1861673246
Provider Name: SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF OTOLARYNGOLOGY
Classification: Otolaryngology - 207YP0228X
Entity Type: Organization

Specialization: Pediatric Otolaryngology

Address:
9300 VALLEY CHILDRENS PL
SE18
MADERA, CA
ZIP 93636
Phone: (559) 353-6453
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SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF OTOLARYNGOLOGY is a pediatric otolaryngology otolaryngology in Madera, CA. The provider is a pediatric otolaryngologist has special expertise in the management of infants and children with disorders that include congenital and acquired conditions involving the aerodigestive tract, nose and paranasal sinuses, the ear and other areas of the head and neck. The pediatric otolaryngologist has special skills in the diagnosis, treatment, and management of childhood disorders of voice, speech, language and hearing. SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF OTOLARYNGOLOGY NPI is 1861673246. 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
SE18
MADERA, CA
ZIP 93636-761
Phone: (559) 353-6453
Fax: (559) 353-6457

The provider's authorized official is Devonna M. Kaji .
The authorized official title is President And Medical Director and has the following contact phone number (559) 353-5016.

The enumeration date for this NPI number is 11/14/2007 and was last updated on 6/28/2013.


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
1207Y00000XOtolaryngologyCALIFORNIANo
2207YP0228XOtolaryngologyPediatric OtolaryngologyCALIFORNIAYes

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
11013968296OTHERCALIFORNIASMG GENERAL GROUP NPI NUMBER
2ZZZ13884ZMEDICARE PINCALIFORNIA
3GR007868JMEDICAIDCALIFORNIA

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

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