Provider Demographics
NPI:1639842404
Name:CALIFORNIA CLINIC PHYSICIANS MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:CALIFORNIA CLINIC PHYSICIANS MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:HOYT
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:865-500-1315
Mailing Address - Street 1:5000 HOPYARD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3146
Mailing Address - Country:US
Mailing Address - Phone:865-500-1315
Mailing Address - Fax:865-694-5113
Practice Address - Street 1:8851 CENTER DR STE 600
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3061
Practice Address - Country:US
Practice Address - Phone:619-740-5724
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty