Organization
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF SURGERY
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 AND MEDICAL DIRECTOR)
(559) 353-5700
Entity
Organization
Contact information
Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-7290
(559) 353-7286
Mailing address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-7290
(559) 353-7286
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
CA
2086S0120X
Pediatric Surgery Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR007868M
—
CA
Enumeration date
12/13/2007
Last updated
12/13/2007
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