# SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA INC. - DEPT OF NEUROLOGY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063691467
- **Legal business name:** SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA INC
- **Authorized official:** DEVONNA M. KAJI M.D. (PRESIDENT / MEDICAL DIRECTOR)
- **Authorized official phone:** (559) 353-5700

## Contact information

- **Practice address:** 9300 VALLEY CHILDRENS PL, MB20, MADERA, CA 93636-8761
- **Practice address phone:** (559) 353-6215
- **Practice address fax:** (559) 353-6222
- **Mailing address:** 9300 VALLEY CHILDRENS PL, MB20, MADERA, CA 93636-8761
- **Mailing address phone:** (559) 353-6215
- **Mailing address fax:** (559) 353-6222

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | CA | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | CA | Yes |

## Other

- **Enumeration date:** 11/01/2007
- **Last updated:** 06/28/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1013968296 | SMG GENERAL GROUP NPI | CA |
| 05 | — | GR0078689 | — | CA |