Healthcare Provider Details
I. General information
NPI: 1275001075
Provider Name (Legal Business Name): CALIFORNIA FAMILY MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/09/2018
Last Update Date: 03/09/2020
Certification Date: 03/09/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1920 CALIFORNIA ST STE A
REDDING CA
96001-1953
US
IV. Provider business mailing address
1920 CALIFORNIA ST STE A
REDDING CA
96001-1953
US
V. Phone/Fax
- Phone: 530-247-7070
- Fax: 530-244-7246
- Phone: 530-247-7070
- Fax: 530-244-7246
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANDREW
SOLKOVITS
Title or Position: CEO
Credential:
Phone: 530-247-7070