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CENTRAL CALIFORNIA FACULTY MEDICAL GROUP INC. NPI 1992742852


NPI Information

NPI: 1992742852
Provider Name: CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
2625 E DIVISADERO ST
FRESNO, CA
ZIP 93721
Phone: (559) 453-5200
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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 1992742852. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2625 E DIVISADERO ST
FRESNO, CA
ZIP 93721-431
Phone: (559) 453-5200
Fax: (559) 443-2681

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 enumeration date for this NPI number is 6/1/2006 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
1207Q00000XFamily MedicineNo
2207RC0000XInternal MedicineCardiovascular DiseaseNo
3207QA0000XFamily MedicineAdolescent MedicineNo
4207QA0505XFamily MedicineAdult MedicineNo
5207RC0200XInternal MedicineCritical Care MedicineNo
6207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
7207RG0100XInternal MedicineGastroenterologyNo
8207RH0003XInternal MedicineHematology & OncologyNo
9207RI0011XInternal MedicineInterventional CardiologyNo
10207RI0200XInternal MedicineInfectious DiseaseNo
11207V00000XObstetrics & GynecologyNo
12208000000XPediatricsNo
132084N0400XPsychiatry & NeurologyNeurologyNo
14213E00000XPodiatristNo
15207R00000XInternal 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
1ZZZ15011ZMEDICARE PIN
2GR0077241MEDICAIDCALIFORNIA
3ZZZ83317ZMEDICAIDCALIFORNIA
4ZZZ83317ZMEDICARE PIN
5GPS000540MEDICAIDCALIFORNIA
6GR0077244MEDICAIDCALIFORNIA
7GRE001360MEDICAIDCALIFORNIA

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.