Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kyrian C Obidiegwu

Individual provider Physician Assistant · NPI 1891309688

Kyrian C Obidiegwu is a Physician Assistant in Clovis, California. Qualified in 2020, 6 years ago. Practices with Community Foundation Medical Group, a 284-clinician group and accepts Medicare assignment.

Years since qualifying
6
In the registry since
2020
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Practice location Address checks out

2021 Herndon Ave # 101
Clovis, CA 93611-6316
Phone: (510) 861-8246
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1891309688
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 31, 2020
Last updated in NPPESOctober 2, 2020
Certification dateOctober 2, 2020
Mailing addressPo Box 25639, Fresno, CA 93729-5639

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Community Foundation Medical Group — 284 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Clovis