Provider Demographics
NPI:1336220557
Name:THE NOBLE GROUP A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:THE NOBLE GROUP A MEDICAL CORPORATION
Other - Org Name:PATIENTS FIRST MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER/COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-383-3990
Mailing Address - Street 1:3144 G ST STE 125
Mailing Address - Street 2:PMB 331
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-1385
Mailing Address - Country:US
Mailing Address - Phone:209-383-7304
Mailing Address - Fax:209-383-7308
Practice Address - Street 1:394 E YOSEMITE AVE STE 200
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-8218
Practice Address - Country:US
Practice Address - Phone:209-383-3990
Practice Address - Fax:209-383-2082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6501890001Medicare NSC
CAMMM00248MMedicare PIN