Organization
COMMUNITY MEDICAL PROVIDERS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT NAKAMURA MD (MEDICAL DIRECTOR)
(559) 228-5400
Entity
Organization
Contact information
Practice address
1180 E SHAW AVE, STE 125, FRESNO, CA 93710-7812
(559) 228-4200
(559) 224-3920
Mailing address
PO BOX 28900, FRESNO, CA 93729
(559) 228-4200
(559) 224-3920
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G50552
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0068690
—
CA
05
—
GR0068691
—
CA
05
—
GR0068692
—
CA
05
—
GR0068693
—
CA
05
—
GR0068694
—
CA
05
—
GR0068695
—
CA
05
—
GR0068696
—
CA
Enumeration date
12/30/2005
Last updated
10/25/2011
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