Organization
COMMUNITY MEDICAL PROVIDERS MEDICAL GROUP INC
Active
Parent organization
MEDVANTX, INC.
Other names
CMP- Urgent Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (VP OF OPERATIONS)
(858) 964-1506
Entity
Organization
Contact information
Practice address
1570 E HERNDON AVE, FRESNO, CA 93720-3303
(559) 437-7304
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A131410
CA
Other
Enumeration date
05/03/2013
Last updated
08/28/2014
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