Provider Demographics
NPI:1144478819
Name:NEONATAL PERINATAL MEDICAL GROUP, INC.
Entity type:Organization
Organization Name:NEONATAL PERINATAL MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:KULDIP
Authorized Official - Middle Name:
Authorized Official - Last Name:THUSU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:559-288-1871
Mailing Address - Street 1:5120 E COPPER AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-8620
Mailing Address - Country:US
Mailing Address - Phone:559-288-1871
Mailing Address - Fax:559-595-1851
Practice Address - Street 1:9300 VALLEY CHILDRENS PL
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93636-8761
Practice Address - Country:US
Practice Address - Phone:559-288-1871
Practice Address - Fax:559-595-1851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA613262080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty