TABLE MOUNTAIN RANCHERIA MEDICAL CENTER
NPI 1093983389
Internal Medicine in Friant, CA

Active since February 20, 2008CLIA 05D1013574 · Waiver
23638 SKY HARBOUR RD, FRIANT, CA 93626(559) 822-3785(559) 822-2928 Get Directions Write a Review

NPPES record last updated: February 20, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Table Mountain Rancheria Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TABLE MOUNTAIN RANCHERIA MEDICAL CENTER (NPI 1093983389) is a healthcare organization registered as an internal medicine in Friant, California and active in the NPI registry since February 2008. The organization holds a CLIA Waiver certificate valid through June 10, 2027 and lists Marilyn O Benck, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1093983389
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameTABLE MOUNTAIN RANCHERIA MEDICAL CENTER
Location Address23638 SKY HARBOUR RDFriant, CA 93626-0410
Mailing AddressPo Box 410Friant, CA 93626-0410 · (559) 822-3785 · Fax (559) 822-2928
Fax(559) 822-2928
Organization SubpartNo
Authorized OfficialMarilyn O BenckMedical Director · (559) 822-3785
Enumeration DateFebruary 20, 2008
NPI 1093983389 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in CA · G42148
Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

23638 SKY HARBOUR RD, Friant, CA 93626

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1013574

Table Mountain Ranchera Medical Center · Friant, CA
Active · expires Jun 10, 2027
CLIA Number05D1013574
Laboratory TypePhysician Office
Certificate Effective DateJune 11, 2025
Certificate Expiration DateJune 10, 2027
Laboratory DirectorMarilyn O. Bench MD
Laboratory Phone(559) 822-3785
Laboratory LocationTable Mountain Ranchera Medical Center23638 Sky Harbour Rd, Friant, CA 93626
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Optometrist
23638 SKY HARBOUR RD
FRIANT, CA 93626

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Table Mountain Rancheria Medical Center's NPI number?

The NPI number for Table Mountain Rancheria Medical Center is 1093983389. It was assigned to this organization in the NPPES registry on February 20, 2008.

Where is Table Mountain Rancheria Medical Center located?

Table Mountain Rancheria Medical Center is located at 23638 Sky Harbour Rd, Friant, CA 93626. The listed phone number is (559) 822-3785.

What is Table Mountain Rancheria Medical Center's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Table Mountain Rancheria Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1013574) is associated with this NPI, valid through June 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Table Mountain Rancheria Medical Center was last updated on February 20, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.