Organization
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF OTOLARYNGOLOGY
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
DEVONNA M. KAJI M.D. (PRESIDENT AND MEDICAL DIRECTOR)
(559) 353-5016
Entity
Organization
Contact information
Practice address
9300 VALLEY CHILDRENS PL, SE18, MADERA, CA 93636-8761
(559) 353-6453
(559) 353-6457
Mailing address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8761
(559) 353-6453
(559) 353-6457
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
—
CA
207YP0228X
Pediatric Otolaryngology Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013968296
SMG GENERAL GROUP NPI NUMBER
CA
05
—
GR007868J
—
CA
Enumeration date
11/14/2007
Last updated
06/28/2013
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