Provider Demographics
NPI:1801824206
Name:OAKHURST EMERGENCY MEDICINE GROUP
Entity Type:Organization
Organization Name:OAKHURST EMERGENCY MEDICINE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SADLEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-228-4298
Mailing Address - Street 1:PO BOX 28916
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-8916
Mailing Address - Country:US
Mailing Address - Phone:559-228-4298
Mailing Address - Fax:559-224-3920
Practice Address - Street 1:48677 VICTORIA LN
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:CA
Practice Address - Zip Code:93644-9216
Practice Address - Country:US
Practice Address - Phone:559-683-2992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA50552146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ03504ZMedicare ID - Type Unspecified