Provider Demographics
NPI:1922109511
Name:FAMILY PHYSICIANS, INC., A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:FAMILY PHYSICIANS, INC., A MEDICAL CORPORATION
Other - Org Name:FAMILY PHYSICIANS INC, A MEDICAL CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:III
Authorized Official - Credentials:DO
Authorized Official - Phone:530-671-2020
Mailing Address - Street 1:1233 PLUMAS ST
Mailing Address - Street 2:STE A
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991
Mailing Address - Country:US
Mailing Address - Phone:530-671-2020
Mailing Address - Fax:530-671-6797
Practice Address - Street 1:1233 PLUMAS ST
Practice Address - Street 2:STE A
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991
Practice Address - Country:US
Practice Address - Phone:530-671-2020
Practice Address - Fax:530-671-6797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA450730OtherLICENSE
CAA95951OtherLICENSE
CAGR0070950Medicaid
20A603930OtherLICENSE PIN
PA13423OtherLICENSE PIN
MM0498419OtherDEA
20A603930OtherLICENSE PIN
AM2876780OtherDEA
PA13423OtherLICENSE PIN
E69592Medicare UPIN
CAE90666Medicare UPIN
CAGR0070950Medicaid
CAA95951OtherLICENSE