NPIMap

Organization Active NPI

Community Regional Anesthesia Medical Group Inc

  • Anesthesiology Physician
  • Clovis, CA
National Provider Identifier
1164587523
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
COMMUNITY REGIONAL ANESTHESIA MEDICAL GROUP INC
Practice address
2755 Herndon Ave
Clovis, CA 93612
Phone
(559) 324-4000
NPI assigned
Dec 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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

Authorized official

Name
Ali Fayed, MDNPI 1316931934
Title
Group President
Phone
(559) 324-4000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

2755 Herndon Ave
Clovis, CA 93612

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

Other identifiers 1

IdentifierTypeStateIssuer
GR0103920MedicaidCA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341187200000",
    "number": "1164587523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 HERNDON AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "93612",
            "telephone_number": "559-324-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY REGIONAL ANESTHESIA MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2012-07-02",
        "status": "A",
        "authorized_official_last_name": "FAYED",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "GROUP PRESIDENT",
        "authorized_official_telephone_number": "559-324-4000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0103920",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; 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.