Healthcare Provider Details

I. General information

NPI: 1528527181
Provider Name (Legal Business Name): PARAGON CHICO MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2019
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 ESPLANADE
CHICO CA
95926-3315
US

IV. Provider business mailing address

1700 ESPLANADE
CHICO CA
95926-3315
US

V. Phone/Fax

Practice location:
  • Phone: 813-385-6847
  • Fax:
Mailing address:
  • Phone: 813-385-6847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: HARRY LOMAS IV
Title or Position: EXECUTOR
Credential: MD
Phone: 813-385-6847