Central California Faculty Medical Group, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.

Practice address

2554 Merced Street
Fresno, CA 93721

Phone

(559) 256-9660

Fax

(559) 489-0499

NPI assigned

Dec 12, 2014

Organization subpart

Yes

Parent organization

CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Karl P Vangundy, MD

Title

President

Phone

(559) 443-2682

Specialties & licenses 1

Addresses

Other names 1

• University Medical Supply Doing business as

Part of

Ccfmg Precision Surgica

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441756800000",
    "number": "1124426705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-443-2682",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2554 MERCED STREET",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93721",
            "telephone_number": "559-256-9660",
            "fax_number": "559-489-0499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.",
        "enumeration_date": "2014-12-12",
        "last_updated": "2015-09-09",
        "status": "A",
        "authorized_official_last_name": "VANGUNDY",
        "authorized_official_first_name": "KARL",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-443-2682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Fresno, CA
• Durable Medical Equipment & Medical Supplies in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.