MEDICARE: COMMUNITY HOSPITALIST MEDICAL GROUP INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467437376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HOSPITALIST MEDICAL GROUP INC.

Provider Business Mailing Address
First Line	:	PO BOX 28901
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-8901
Country	:	US
Telephone Number	:	559-228-4222
Fax Number	:	559-224-3920

Provider Business Practice Location Address
First Line	:	1180 E SHAW AVE
Second Line	:	SUITE 101
City	:	FRESNO
State	:	CA
Zip	:	93710-7812
Country	:	US
Telephone Number	:	559-228-4222
Fax Number	:	559-228-4299

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GRANT NAKAMURA
Credential	:	M. D.
Telephone Number	:	559-228-5400

Provider Enumeration Date	:	12/13/2005
Last Update Date	:	08/13/2007

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