NPIMap

Organization Active NPI

Specialty Medical Group Central California - Dept of Internal Medicine

  • Pediatrics Physician
  • Madera, CA
National Provider Identifier
1326229709
Registry record updated Nov 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF INTERNAL MEDICINE
Practice address
9300 Valley Childrens PL
Madera, CA 93636-8761
Phone
(559) 353-5068
Fax
(559) 353-5426
NPI assigned
Nov 14, 2007
Organization subpart
Yes
Parent organization
SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 14, 2007

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

Authorized official

Name
Ralph P. Diaz, M.D.
Title
President/Medical Director
Phone
(559) 353-5700

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X Primary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X CA

Addresses

Primary practice location

9300 Valley Childrens PL
Madera, CA 93636-8761

Mailing address

9300 Valley Childrens PL
Madera, CA 93636-8761
Phone (559) 353-5068

Other identifiers 1

IdentifierTypeStateIssuer
GR007868EMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Vly Child Spec Med GRP Inc29 organizations share this tax ID, including this one
Part of
Vly Child Spec Med GRP Inc

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

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": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1326229709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5068",
            "fax_number": "559-353-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 VALLEY CHILDRENS PL",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936368761",
            "telephone_number": "559-353-5068",
            "fax_number": "559-353-5426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA - DEPT OF INTERNAL MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALTY MEDICAL GROUP CENTRAL CALIFORNIA, INC.",
        "enumeration_date": "2007-11-14",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "559-353-5700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR007868E",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; 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.