Healthcare Provider Details

I. General information

NPI: 1902528441
Provider Name (Legal Business Name): THE MEDICAL PARTNERS GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

568 E HERNDON AVE STE 102
FRESNO CA
93720-2989
US

IV. Provider business mailing address

568 E HERNDON AVE STE 102
FRESNO CA
93720-2989
US

V. Phone/Fax

Practice location:
  • Phone: 559-221-7500
  • Fax:
Mailing address:
  • Phone: 559-221-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ERICA VEGA
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 559-710-1200