Organization
CENTRAL CALIF ENT MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDI BARTUCCI (DIRECTOR OF ACCTS. RECEIVABLE)
(559) 432-3303
Entity
Organization
Contact information
Practice address
1351 E SPRUCE AVE, FRESNO, CA 93720-3342
(559) 432-3303
(559) 432-1468
Mailing address
1351 E SPRUCE AVE, FRESNO, CA 93720-3342
(559) 432-3303
(559) 432-1468
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0070230
—
CA
01
—
ZZZ49290Z
BLUE CROSS
CA
Enumeration date
03/21/2006
Last updated
09/11/2025
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