Organization
FIRSTCHOICE MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE LUIS BAUTISTA M.D. (PRESIDENT)
(559) 445-0391
Entity
Organization
Contact information
Practice address
1350 O ST, SUITE 301, FRESNO, CA 93721-1828
(559) 500-2002
Mailing address
1350 O ST, SUITE 301, FRESNO, CA 93721-1828
(559) 500-2002
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
06/02/2014
Last updated
06/02/2014
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