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Contact Information

SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF OTOLARYNGOLOGY
9300 VALLEY CHILDRENS PL
SE18
MADERA, CA93636-8761
 Phone: 559-353-6453
 Fax: 559-353-6457
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Otolaryngology

207YP0228X 04 Physician/Otolaryngology
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF OTOLARYNGOLOGY

NPI # 1861673246
LBN Legal business name SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF OTOLARYNGOLOGY
Authorized official DEVONNA KAJI - (PRESIDENT AND MEDICAL DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 11/14/2007
Last updated 06/28/2013 - About 13 years ago
Identifiers
CA Medicaid GR007868J
CA Other 1013968296 SMG GENERAL GROUP NPI NUMBER
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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