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Organization

CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.

Active
Parent organization
CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.
Authorized official
VICKIE PICCOLO (PHYSICIAN SERVICES MANAGER)
(559) 443-2682
Entity
Organization

Contact information

Practice address
2823 FRESNO ST, FRESNO, CA 93721-1324
(559) 443-2682
(559) 443-2681
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary

Other

Enumeration date
10/12/2012
Last updated
10/22/2024
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