Organization Active NPI

Central California Faculty Medical Group, Inc.

  • Internal Medicine Physician
  • Clovis, CA
National Provider Identifier
1992742852
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.
Practice address
604 N Magnolia Ave Ste 100
Clovis, CA 93611-9205
Phone
(559) 320-0531
Fax
(559) 320-0539
NPI assigned
Jun 1, 2006
Last updated
Jun 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Authorized official

Name
Randall Stern, MDNPI 1962512319
Title
President
Phone
(559) 443-2682

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Adolescent Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0000X
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Cardiovascular Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0000X
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Hematology & Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0003X
Interventional Cardiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0011X
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X

Addresses

Primary practice location

604 N Magnolia Ave Ste 100
Clovis, CA 93611-9205

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431
Phone (559) 453-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031118001168 CA Part B Supplier - Clinic/Group Practice 8325952773 Receives reassigned benefits from 333 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fresno, CA; Madera, CA; Clovis, CA
O20250613002516 CA DME Supplier - Physician - Internal Medicine 8325952773 Practice locations: Clovis, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

729 N Medical Center Dr W
Ste 11
Clovis, CA 93611

2027 E Divisadero St
Fresno, CA 93701
Phone (559) 320-0580

2027 E Divisadero St
Ste 227
Fresno, CA 93701

2210 E Illinois Ave
Ste 204
Fresno, CA 93701

2210 E Illinois Ave
Ste 302
Fresno, CA 93701

2210 E Illinois Ave
Ste 401
Fresno, CA 93701
Phone (559) 320-0531

2210 E Illinois Ave
Ste 508
Fresno, CA 93701
Phone (559) 320-0545

2335 E Kashian Ln
Fresno, CA 93701
Phone (559) 445-1251

2335 E Kashian Ln
Ste 1301
Fresno, CA 93701

2335 E Kashian Ln
Ste 310
Fresno, CA 93701

2335 E Kashian Ln
Ste 410
Fresno, CA 93701
Phone (559) 266-4100

2823 Fresno St
Fl 5
Fresno, CA 93721

2900 Fresno St
Ste 101
Fresno, CA 93721
Phone (559) 227-4472

351 E Barstow Ave
Ste 106
Fresno, CA 93710
Phone (559) 227-4472

4011 N Fresno St
Ste 103
Fresno, CA 93726
Phone (209) 224-2100

4440 N 1st St
Fresno, CA 93726
Phone (559) 225-1102

445 S Cedar Ave
Fresno, CA 93702
Phone (559) 459-4000

6311 N Fresno St
Ste 106
Fresno, CA 93710
Phone (559) 435-4700

7011 N Howard St
Ste 100
Fresno, CA 93720
Phone (559) 272-8141

7015 N Chestnut Ave
Fresno, CA 93720
Phone (559) 475-0357

7025 N Chestnut Ave
Ste 105
Fresno, CA 93720
Phone (559) 233-3376

2511 Logan St
Selma, CA 93662
Phone (209) 896-2624

2101 Stone Blvd
Ste 240
West Sacramento, CA 95691
Phone (916) 376-8416

Practitioners & affiliated clinicians

Practitioners 447

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 447

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1992742852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 E DIVISADERO ST",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937211431",
            "telephone_number": "559-453-5200",
            "fax_number": "559-443-2681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 N MAGNOLIA AVE STE 100",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936119205",
            "telephone_number": "559-320-0531",
            "fax_number": "559-320-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL CALIFORNIA FACULTY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-443-2682",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.