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Organization

SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF PHYSIATRY

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) 353-5016
Entity
Organization

Contact information

Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-5700
(559) 353-5708
Mailing address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-5700
(559) 353-5708

Taxonomy

Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR007868H
CA
Enumeration date
11/14/2007
Last updated
11/14/2007
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