# SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF PHYSIATRY

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

## Provider details

- **NPI number:** 1316128796
- **Legal business name:** SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA, INC.
- **Authorized official:** RALPH P. DIAZ M.D. (PRESIDENT AND MEDICAL DIRECTOR)
- **Authorized official phone:** (559) 353-5016

## Contact information

- **Practice address:** 9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
- **Practice address phone:** (559) 353-5700
- **Practice address fax:** (559) 353-5708
- **Mailing address:** 9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
- **Mailing address phone:** (559) 353-5700
- **Mailing address fax:** (559) 353-5708

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P0010X | Pediatric Rehabilitation Medicine Physician | — | CA | Yes |

## Other

- **Enumeration date:** 11/14/2007
- **Last updated:** 11/14/2007