# MERIDIAN MEDICAL GROUP, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932380383
- **Authorized official:** DR. ALBERT GOMEZ M.D. (PRESIDENT)
- **Authorized official phone:** (209) 624-5288

## Contact information

- **Practice address:** 330 NORTHGATE DR, MANTECA, CA 95336-3139
- **Practice address phone:** (209) 624-5288
- **Practice address fax:** (209) 624-5289
- **Mailing address:** PO BOX 3278, SAN JOSE, CA 95156-3278
- **Mailing address phone:** (209) 624-5288
- **Mailing address fax:** (209) 624-5289

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | CA | Yes |

## Other

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

## 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 |