Provider Demographics
NPI:1023158052
Name:COMPLETE FAMILY CARE MEDICAL CORP
Entity type:Organization
Organization Name:COMPLETE FAMILY CARE MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SETHU
Authorized Official - Middle Name:V
Authorized Official - Last Name:MADHAVAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-945-7181
Mailing Address - Street 1:867 W. LANCASTER BLVD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534
Mailing Address - Country:US
Mailing Address - Phone:661-945-7181
Mailing Address - Fax:661-942-6008
Practice Address - Street 1:867 W LANCASTER BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2348
Practice Address - Country:US
Practice Address - Phone:661-945-7181
Practice Address - Fax:661-942-6008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW13399Medicare ID - Type UnspecifiedGROUP NUMBER