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Organization

CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RANDALL STERN MD (PRESIDENT)
(559) 443-2682
Entity
Organization

Contact information

Practice address
604 N MAGNOLIA AVE STE 100, CLOVIS, CA 93611-9205
(559) 320-0531
(559) 320-0539
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 453-5200
(559) 443-2681

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207QA0000X
Adolescent Medicine (Family Medicine) Physician
207QA0505X
Adult Medicine Physician
207R00000X
Internal Medicine Physician
Primary
207RC0000X
Cardiovascular Disease Physician
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RG0100X
Gastroenterology Physician
207RH0003X
Hematology & Oncology Physician
207RI0011X
Interventional Cardiology Physician
207RI0200X
Infectious Disease Physician
207V00000X
Obstetrics & Gynecology Physician
208000000X
Pediatrics Physician
2084N0400X
Neurology Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GPS000540
CA
05
GR0077241
CA
05
GR0077244
CA
05
GRE001360
CA
05
ZZZ83317Z
CA
Enumeration date
06/01/2006
Last updated
06/13/2025
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