Organization
CENTRAL CALIFORNIA NEONATOLOGY GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHETAN A. PATEL MD (PRESIDENT)
(559) 353-3000
Entity
Organization
Contact information
Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-3000
Mailing address
3116 W MARCH LN, SUITE 200, STOCKTON, CA 95219-2369
(209) 473-6555
(209) 473-6544
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CA
Enumeration date
06/18/2012
Last updated
06/18/2012
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