Provider Demographics
NPI:1184295198
Name:C & A MEDICAL GROUP CORP
Entity type:Organization
Organization Name:C & A MEDICAL GROUP CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:AZADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-567-3288
Mailing Address - Street 1:3000 ALAMO DR STE 102
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95687-6345
Mailing Address - Country:US
Mailing Address - Phone:707-567-3288
Mailing Address - Fax:
Practice Address - Street 1:3000 ALAMO DR STE 102
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-6345
Practice Address - Country:US
Practice Address - Phone:707-567-3288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-09
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty