Organization Active NPI

Forensic Medical Group, Inc.

  • Forensic Pathology Physician
  • Fairfield, CA
National Provider Identifier
1316962897
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic Pathology PhysicianTaxonomy code 207ZF0201X
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

Updated by the provider on Jul 21, 2022

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)CodeLicenseStatePrimary
Forensic Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

Locations

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.

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.

Verify at the official NPI Registry.