Organization Active NPI

Julian R Fuentes MD Inc

  • Family Medicine Physician
  • Redding, CA
National Provider Identifier
1720370380
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A50122 Issued in CA
Legal business name
JULIAN R FUENTES MD INC
Practice address
3330 Churn Creek Rd
Ste D4
Redding, CA 96002-2532
Phone
(530) 222-3287
Fax
(530) 222-8547
NPI assigned
May 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Authorized official

Name
Julian Fuentes, MD
Title
President
Phone
(530) 222-3287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X A50122 CA Primary

Addresses

Primary practice location

3330 Churn Creek Rd
Ste D4
Redding, CA 96002-2532

Mailing address

PO Box 991868
Redding, CA 96099-1868
Phone (530) 339-0025

Other identifiers 1

IdentifierTypeStateIssuer
C3373967OtherCACOPORATE NUMBER

National Provider Directory

National Provider Directory

Locations

3330 Churn Creek Rd
Ste B3
Redding, CA 96002
Phone (530) 222-1492

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": "1305244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1720370380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 991868",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960991868",
            "telephone_number": "530-339-0025",
            "fax_number": "530-722-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 CHURN CREEK RD",
            "address_2": "STE D4",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960022532",
            "telephone_number": "530-222-3287",
            "fax_number": "530-222-8547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JULIAN R FUENTES MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-13",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "FUENTES",
        "authorized_official_first_name": "JULIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-222-3287",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A50122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COPORATE NUMBER",
            "identifier": "C3373967",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.