Provider Demographics
NPI:1205218005
Name:CALIFORNIA FORENSIC MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:CALIFORNIA FORENSIC MEDICAL GROUP, INC.
Other - Org Name:CFMG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:KARL
Authorized Official - Last Name:HERR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-901-3278
Mailing Address - Street 1:2511 GARDEN ROAD
Mailing Address - Street 2:SUITE A160
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940
Mailing Address - Country:US
Mailing Address - Phone:831-649-8994
Mailing Address - Fax:831-649-8286
Practice Address - Street 1:2584 W SANDY MUSH RD
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-8713
Practice Address - Country:US
Practice Address - Phone:209-385-7618
Practice Address - Fax:209-385-7480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-29
Last Update Date:2017-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility