Organization
COMMUNITY PERINATOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK STUART D.O. (PRESIDENT)
(559) 228-4298
Entity
Organization
Contact information
Practice address
110 N VALERIA ST, SUITE 204, FRESNO, CA 93701-2166
(559) 233-7700
(559) 233-7744
Mailing address
PO BOX 28913, FRESNO, CA 93729-8913
(559) 228-4298
(559) 224-3920
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A48104
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0100510
—
CA
Enumeration date
07/13/2006
Last updated
05/19/2010
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