Organization
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT. OF NEPHROLOGY
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 / MEDICAL DIRECTOR)
(559) 353-5700
Entity
Organization
Contact information
Practice address
9300 VALLEY CHILDRENS PL, SE13, MADERA, CA 93636-8761
(559) 353-5770
(559) 353-5822
Mailing address
9300 VALLEY CHILDRENS PL, SE13, MADERA, CA 93636-8761
(559) 353-5770
(559) 353-5822
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
CA
2080P0210X
Pediatric Nephrology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR007868A
—
CA
Enumeration date
11/16/2007
Last updated
11/16/2007
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