Organization · NPI-2

Central California Faculty Medical Group, INC.

Internal Medicine · Clovis, CA

NPI number1992742852

StatusActive

Last updated in NPPESJun 13, 2025

Details

NPI: 1992742852
Entity type: Organization (NPI-2)
Legal business name: Central California Faculty Medical Group, INC.
Organization subpart: No
Enumeration date: Jun 1, 2006
Certification date: Jun 13, 2025
Last updated: Jun 13, 2025

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207R00000X	Internal Medicine	–	–	Yes
207V00000X	Obstetrics & Gynecology	–	–
208000000X	Pediatrics	–	–
2084N0400X	Psychiatry & Neurology, Neurology	–	–
207Q00000X	Family Medicine	–	–
207QA0000X	Family Medicine, Adolescent Medicine	–	–
207QA0505X	Family Medicine, Adult Medicine	–	–
207RC0000X	Internal Medicine, Cardiovascular Disease	–	–
207RC0200X	Internal Medicine, Critical Care Medicine	–	–
207RE0101X	Internal Medicine, Endocrinology, Diabetes & Metabolism	–	–
207RG0100X	Internal Medicine, Gastroenterology	–	–
207RH0003X	Internal Medicine, Hematology & Oncology	–	–
207RI0011X	Internal Medicine, Interventional Cardiology	–	–
207RI0200X	Internal Medicine, Infectious Disease	–	–

Practice location

604 N Magnolia Ave Ste 100
Clovis, CA 93611-9205

Phone 559-320-0531 · Fax 559-320-0539

Mailing address

2625 E Divisadero St
Fresno, CA 93721-1431

Phone 559-453-5200 · Fax 559-443-2681

Authorized official

Randall Stern
President
5594432682

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