# CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.
- **Other names:** University Medical Supply
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124426705
- **Legal business name:** CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.
- **Authorized official:** DR. KARL P VANGUNDY MD (PRESIDENT)
- **Authorized official phone:** (559) 443-2682

## Contact information

- **Practice address:** 2554 MERCED STREET, FRESNO, CA 93721
- **Practice address phone:** (559) 256-9660
- **Practice address fax:** (559) 489-0499
- **Mailing address:** 2625 E DIVISADERO ST, FRESNO, CA 93721-1431
- **Mailing address phone:** (559) 443-2682
- **Mailing address fax:** (559) 443-2681

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 12/12/2014
- **Last updated:** 09/09/2015