Active NPI
Forensic Medical Group, Inc.
- Forensic Pathology Physician
- Fairfield, CA
National Provider Identifier
1316962897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Pathology Physician
- Legal business name
- FORENSIC MEDICAL GROUP, INC.
- Practice address
- 1860 Pennsylvania Ave
#150
Fairfield, CA 94533 - Phone
- (707) 426-4883
- NPI assigned
- Jul 13, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brian Peterson, M.D.
- Title
- Managing Partner
- Phone
- (707) 426-4883
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Pathology Physician | 207ZF0201X | CA | Primary |
Addresses
Primary practice location
1860 Pennsylvania Ave
#150
Fairfield, CA 94533
Mailing address
PO Box 26060
Fresno, CA 94533
Phone (559) 455-4000
National Provider Directory
National Provider DirectoryLocations
1860 Pennsylvania Ave
Ste 150
Fairfield, CA 94533
Phone (707) 426-1583
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Forensic Pathology Physician
- Fairfield, CA
- NPI 1801802848
-
- Forensic Pathology Physician
- Fairfield, CA
- NPI 1083647622
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1316962897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26060",
"city": "FRESNO",
"state": "CA",
"postal_code": "94533",
"telephone_number": "559-455-4000",
"fax_number": "559-455-4007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1860 PENNSYLVANIA AVE",
"address_2": "#150",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "94533",
"telephone_number": "707-426-4883"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FORENSIC MEDICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-13",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "PETERSON",
"authorized_official_first_name": "BRIAN",
"authorized_official_title_or_position": "MANAGING PARTNER",
"authorized_official_telephone_number": "707-426-4883",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207ZF0201X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pathology, Forensic Pathology",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.