Provider Demographics
NPI:1326692492
Name:CONTINUUM FAMILY HEALTH MEDICAL CORPORATION
Entity Type:Organization
Organization Name:CONTINUUM FAMILY HEALTH MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:209-728-5035
Mailing Address - Street 1:13949 MONO WAY
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-2807
Mailing Address - Country:US
Mailing Address - Phone:209-213-9184
Mailing Address - Fax:
Practice Address - Street 1:13949 MONO WAY
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-2807
Practice Address - Country:US
Practice Address - Phone:209-213-9184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-27
Last Update Date:2019-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0OtherWILL ENROLL IN MEDICARE ONCE NPI IS RECEIVED