Organization
COMMUNITY FOUNDATION MEDICAL GROUP
Active
Parent organization
COMMUNITY FOUNDATION MEDICAL GROUP
Other names
Sante' Foundation Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY FOUNDATION MEDICAL GROUP
Authorized official
SCOTT B WELLS (CEO/PRESIDENT)
(559) 228-5429
Entity
Organization
Contact information
Practice address
7370 N PALM AVE STE 101, FRESNO, CA 93711-5782
(559) 228-5400
Mailing address
PO BOX 28949, FRESNO, CA 93729-8949
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
CA
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
CA
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GG694A
—
CA
Enumeration date
02/21/2017
Last updated
03/09/2023
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