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Contact Information

FREMONT RIDEOUT MEDICAL GROUP INC
726 FOURTH STREET
MARYSVILLE, CA95901
 Phone: 530-749-4300
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for FREMONT RIDEOUT MEDICAL GROUP INC

NPI # 1043263551
LBN Legal business name FREMONT RIDEOUT MEDICAL GROUP INC
Authorized official ROBERT SERAFIN - (GROUP PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/18/2006
Last updated 12/07/2007 - About 19 years ago
Identifiers
CA Medicaid GR0092251
CA Other ZZZ048062 BLUE SHIELD OF CA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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