Organization
FAMILY CARE PROVIDERS MEDICAL GROUP,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY MCKENNEY (ADMINISTRATOR)
(559) 495-6758
Entity
Organization
Contact information
Practice address
1300 N FRESNO ST, FRESNO, CA 93703-3845
(559) 495-6702
(559) 495-6781
Mailing address
1300 N FRESNO ST, FRESNO, CA 93703-3845
(559) 495-6702
(559) 495-6781
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX59230
—
CA
Enumeration date
10/26/2006
Last updated
08/22/2020
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