Provider Demographics
NPI:1467497578
Name:COMPREHENSIVE RENAL CARE GROUP A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:COMPREHENSIVE RENAL CARE GROUP A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-892-2300
Mailing Address - Street 1:PO BOX 6789
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-6789
Mailing Address - Country:US
Mailing Address - Phone:530-892-2300
Mailing Address - Fax:530-894-5890
Practice Address - Street 1:285 COHASSET RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2243
Practice Address - Country:US
Practice Address - Phone:530-892-2300
Practice Address - Fax:530-894-5890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0100320Medicaid
DC5283OtherMEDICARE RAILROAD #
CAZZZ31119ZMedicare PIN