| Doe Medical Inc | |
|
30 E River Park Pl W Ste 320 Fresno CA 93720-1539 | |
| (559) 412-8910 | |
| (559) 492-1111 |
| Full Name | Doe Medical Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 30 E River Park Pl W, Fresno, California |
| Authorized Official Name and Position | Marian Doe (PRESIDENT/CEO) |
| Authorized Official Contact | 5594128910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Doe Medical Inc 30 E River Park Pl W Ste 320 Fresno CA 93720-1539 Ph: (559) 412-8910 | Doe Medical Inc 30 E River Park Pl W Ste 320 Fresno CA 93720-1539 Ph: (559) 412-8910 |
| NPI Number | 1720471444 |
|---|---|
| Provider Enumeration Date | 03/05/2015 |
| Last Update Date | 09/25/2015 |
| Medicare PECOS PAC ID | 2668792805 |
|---|---|
| Medicare Enrollment ID | O20150529000059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720471444 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A105109 (California) | Primary |
| Provider Name | Marian Doe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861640997 PECOS PAC ID: 7214082007 Enrollment ID: I20090831000388 |
| Provider Name | Jennifer M Delayo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922382589 PECOS PAC ID: 4789805607 Enrollment ID: I20141017001981 |
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