# CENTRAL VALLEY CARDIOVASCULAR MEDICAL GROUP, INC

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

## Provider details

- **NPI number:** 1962750224
- **Authorized official:** DR. REZA NAZARI M.D. (CEO)
- **Authorized official phone:** (209) 602-6684

## Contact information

- **Practice address:** 1508 COLORADO AVE, TURLOCK, CA 95380-2711
- **Practice address phone:** (209) 668-8030
- **Practice address fax:** (209) 668-8031
- **Mailing address:** PO BOX 4978, MODESTO, CA 95352-4978
- **Mailing address phone:** (209) 575-4575
- **Mailing address fax:** (209) 575-4598

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 40507 | CA | Yes |

## Other

- **Enumeration date:** 08/16/2012
- **Last updated:** 03/24/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1439840 | — | CA |
| 01 | — | GO094A | MEDICARE | CA |