Provider Demographics
NPI:1558672626
Name:CALIFORNIA COLON AND RECTAL CANCER SCREENING CENTER LLC
Entity Type:Organization
Organization Name:CALIFORNIA COLON AND RECTAL CANCER SCREENING CENTER LLC
Other - Org Name:CALIFORNIA COLON ANDD RECTAL CANCER SCREENING CENTER LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAEEM
Authorized Official - Middle Name:M
Authorized Official - Last Name:AKHTAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-438-0017
Mailing Address - Street 1:451 E ALMOND AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5562
Mailing Address - Country:US
Mailing Address - Phone:559-438-0017
Mailing Address - Fax:559-438-8882
Practice Address - Street 1:7121 N WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0000
Practice Address - Country:US
Practice Address - Phone:559-438-0017
Practice Address - Fax:559-438-8882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-23
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical