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Organization
MADERA FAMILY MEDICAL GROUP INC.
Active
Organization
MADERA FAMILY MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AFTAB A NAZ (PRESIDENT)
(559) 673-3000
Entity
Organization
Contact information
Practice address
1111 W 4TH ST, MADERA, CA 93637-4474
(559) 673-3000
(559) 662-2910
Mailing address
1111 W 4TH ST, MADERA, CA 93637-4474
(559) 673-3000
(559) 662-2910
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH05081
CHDP LAB
CA
05
—
GR0068140
—
CA
01
—
LAB13493F
MCAID LAB#
CA
Enumeration date
09/08/2006
Last updated
03/23/2022
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