PROSPICE MEDICAL GROUP CORPORATION (NPI# 1750562336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750562336 |
| Entity Type | Organization |
| Organization Name | PROSPICE MEDICAL GROUP CORPORATION |
| Practice Address |
4770 N Cedar Ave Fresno CA 93726-1065 |
| Mailing Address |
3065 Richmond Pkwy Suite 102 Richmond CA 94806-5719 |
| Practice Telephone | 5592266824 |
| Mailing Telephone | 5109326208 |
| Enumeration Date | 2007-11-23 |
| Last Update Date | 2008-03-30 |
| Authorized Official Name | ROGER WILLIAM SHORTZ (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 5109326208 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | A46453 | CA | Allopathic & Osteopathic Physicians |
| N | 207T00000X | Neurological Surgery | G10280 | CA | Allopathic & Osteopathic Physicians |
| N | 208100000X | Physical Medicine & Rehabilitation | A40212 | CA | Allopathic & Osteopathic Physicians |
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
A77502 | CA | Allopathic & Osteopathic Physicians |
| Y | 207T00000X | Neurological Surgery | C35999 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
4770 N CEDAR AVE |
| City | FRESNO |
| State | CA |
| Zip Code | 93726-1065 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912532342 | Kurene Mei-ho Fong | Physician Assistant | 4770 N Cedar Ave, Fresno, CA 93726-1065 | 2020-03-05 |
| 1033627179 | Greater Fresno Health Organization, Inc. | Clinic/Center | 4770 N Cedar Ave, Fresno, CA 93726-1065 | 2018-01-10 |
| 1093021008 | Audrey Isabella Archila | Physician Assistant | 4770 N Cedar Ave, Fresno, CA 93726-1065 | 2010-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528520814 | Tania Grijalva Miranda | Behavior Technician | 4910 E. Ashland Ave, Fresno, CA 93726 | 2019-04-04 |
| 1790249894 | Lags Spine and Sportscare Medical Centers, Inc. | Psychologist | 3751 E Shields Avenue, Fresno, CA 93726 | 2019-01-23 |
| 1013481100 | Jill A Perricone | Respiratory Therapist, Registered | 4785 N First St, Fresno, CA 93726 | 2019-01-11 |
| 1285108399 | Leann Lokelani Benton | Respiratory Therapist, Registered | 4785 N. First St, Fresno, CA 93726 | 2019-01-11 |
| 1548745912 | Alina Gonzalez | Counselor | 4440 N. First St., Fresno, CA 93726 | 2018-10-01 |
| 1336622067 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 3751 E Shields Ave, Fresno, CA 93726 | 2018-09-10 |
| 1730676206 | Joanne K Groves | Counselor | 3636 N. First Street, St. 123, Fresno, CA 93726 | 2018-04-19 |
| 1356865679 | Fresno Mental Psychological Health Services, P.C. | Clinic/Center | 4021 N Fresno Street, Ste. 101, Fresno, CA 93726 | 2017-07-28 |
| 1205358819 | Jetinder Singh Ghag | Counselor | 3636 N.first St # 135 and 154, Fresno, CA 93726 | 2017-07-14 |
| 1164897328 | Karam Um Dds Inc | Dentist | 4747 N. First St. #174, Fresno, CA 93726 | 2015-12-14 |
| Find all providers in zip 93726 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336500438 | Sierra Pacific Neurosurgical Associates, A Professional Medical Corp | Neurological Surgery | 7255 N Cedar Ave Ste 102, Fresno, CA 93720-3831 | 2016-03-16 |
| 1235344656 | John Thomas Bonner | Neurological Surgery | 1551 W Escalon Ave, Fresno, CA 93711-1935 | 2007-05-11 |
| 1205971595 | Central California Faculty Medical Group, Inc. | Neurological Surgery | 7415 N Cedar Ave, Suite 102, Fresno, CA 93720-3834 | 2007-02-21 |
| 1972648160 | California Neurological Surgery | Neurological Surgery | 1111 East Herndon Ave, Suite 209, Fresno, CA 93720 | 2007-02-21 |
| 1902947252 | Fresno Neurosurgical Medical Group, Inc | Neurological Surgery | 7797 N 1st St # 18, Fresno, CA 93720-0962 | 2007-02-09 |
| 1578509907 | V Roy Smith | Neurological Surgery | 7797 N 1st St, Pmb 18, Fresno, CA 93720-0962 | 2006-06-22 |
| 1548243389 | Mark Levy | Neurological Surgery | 45 E River Park Pl W, Suite 104, Fresno, CA 93720-1562 | 2005-11-25 |
| 1548242589 | Derek Allan Taggard | Neurological Surgery | 45 E River Park Pl W Ste 104, Fresno, CA 93720-1565 | 2005-11-16 |
| 1811998248 | Adam Brant | Neurological Surgery | 7130 N Sharon Ave, Ste 100, Fresno, CA 93720-3386 | 2005-08-09 |
| 1063884757 | Nathan Deis | Neurological Surgery | 45 E River Park Pl W Ste 104, Fresno, CA 93720-1565 | 2015-10-21 |
| Find all providers in FRESNO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.