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Organization
MERIDIAN MEDICAL GROUP, P.C.
Active
Organization
MERIDIAN MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT GOMEZ M.D. (PRESIDENT)
(209) 624-5288
Entity
Organization
Contact information
Practice address
330 NORTHGATE DR, MANTECA, CA 95336-3139
(209) 624-5288
(209) 624-5289
Mailing address
PO BOX 3278, SAN JOSE, CA 95156-3278
(209) 624-5288
(209) 624-5289
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134228752
NPI NUMBER
CA
01
—
1457439572
NPI NUMBER
CA
01
—
1720171598
NPI NUMBER
CA
01
—
1730273855
NPI NUMBERS
CA
01
—
1972602464
NPI NUMBERS
CA
05
—
GR0070180
—
CA
05
—
GR0070181
—
CA
05
—
GR0070182
—
CA
01
—
ZZZ41448Z
BLUE SHIELD
CA
Enumeration date
11/14/2007
Last updated
11/14/2007
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