Provider Demographics
NPI:1962011734
Name:CESCA MEDICAL GROUP INC
Entity Type:Organization
Organization Name:CESCA MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCESCA
Authorized Official - Middle Name:CHINWE
Authorized Official - Last Name:MEPHORS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-200-3333
Mailing Address - Street 1:15424 HAWTHORNE BLVD STE 302
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-2175
Mailing Address - Country:US
Mailing Address - Phone:424-310-2707
Mailing Address - Fax:
Practice Address - Street 1:15424 HAWTHORNE BLVD STE 302
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-2175
Practice Address - Country:US
Practice Address - Phone:424-310-2707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty