3 Musketeers Medical Group, a Medical Corporation
Organization Active NPI Internal Medicine Physician · Fresno, CA
NPI 1306561030 · NPPES record last updated Nov 21, 2022
Key facts
- NPI
- 1306561030
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- 3 MUSKETEERS MEDICAL GROUP, A MEDICAL CORPORATION
- Practice address
- 7455 N Fresno St Ste 202
Fresno, CA 93720-2481 - Phone
- (559) 942-1223
- NPI assigned
- Oct 5, 2022
- Organization subpart
- No
Authorized official
- Name
- Jiakun Wang
- Title
- President
- Phone
- (615) 423-9545
Practitioners 5
-
Michelle A Thomas, M.D.
-
Jiakun Wang, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221121001500 | CA | Part B Supplier - Clinic/Group Practice | 8325416480 |
Receives reassigned benefits from 5 practitioners Practice locations: Fresno, CA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
7455 N Fresno St Ste 202
Fresno, CA 93720-2481
Mailing address
7455 N Fresno St Ste 202
Fresno, CA 93720-2481
Phone (559) 942-1223
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All providers in Fresno, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.