Provider Demographics
NPI:1033318464
Name:SAN JOAQUIN ACCIDENT AND MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:SAN JOAQUIN ACCIDENT AND MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:ARAKELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:559-222-3400
Mailing Address - Street 1:4559 N CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-2540
Mailing Address - Country:US
Mailing Address - Phone:559-222-3400
Mailing Address - Fax:559-222-6515
Practice Address - Street 1:4559 N CEDAR AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-2540
Practice Address - Country:US
Practice Address - Phone:559-222-3400
Practice Address - Fax:559-222-6515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty