Healthcare Provider Details

I. General information

NPI: 1578598595
Provider Name (Legal Business Name): DELTA SIERRA MEDICAL GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HOSPITAL RD
FRENCH CAMP CA
95231-0000
US

IV. Provider business mailing address

PO BOX 511805
LOS ANGELES CA
90051-1800
US

V. Phone/Fax

Practice location:
  • Phone: 209-473-6555
  • Fax: 209-473-6544
Mailing address:
  • Phone: 209-473-6555
  • Fax: 209-473-6544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMESH DHARAWAT
Title or Position: MANAGER/MD
Credential: MD
Phone: 209-473-6555