Provider Demographics
NPI:1144233487
Name:PERINATAL ASSOCIATES OF CENTRAL CALIFORNIA MEDICAL GROUP INC
Entity Type:Organization
Organization Name:PERINATAL ASSOCIATES OF CENTRAL CALIFORNIA MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:HELM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-268-8307
Mailing Address - Street 1:2273 E BEECHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-0329
Mailing Address - Country:US
Mailing Address - Phone:559-268-8307
Mailing Address - Fax:559-268-0650
Practice Address - Street 1:2210 E ILLINOIS AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2184
Practice Address - Country:US
Practice Address - Phone:559-268-8307
Practice Address - Fax:559-268-0650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0062420Medicaid
CAZZZ195782OtherBLUE SHIELD
CAGR0062420Medicaid