Organization
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF GENETICS
Active
Organization
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF GENETICS
Active
Parent organization
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA, INC.
Authorized official
RALPH P. DIAZ M.D. (PRESIDENT AND MEDICAL DIRECTOR)
(559) 353-5700
Entity
Organization
Contact information
Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-6400
(559) 353-7213
Mailing address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-6400
(559) 353-7213
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
—
CA
208000000X
Pediatrics Physician
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0078685
—
CA
Enumeration date
09/27/2007
Last updated
09/27/2007
Update your record
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