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6191 N Fresno St Suite 101 Fresno CA 93710-8612 | |
(559) 227-1663 | |
(559) 227-9083 |
Full Name | |
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Speciality | Family Medicine |
Location | 6191 N Fresno St, Fresno, California |
Authorized Official Name and Position | Antonio Villalvazo (OWNER) |
Authorized Official Contact | 5592271663 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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6191 N Fresno St Suite 101 Fresno CA 93710-8612 Ph: (559) 227-1663 | 6191 N Fresno St Suite 101 Fresno CA 93710-8612 Ph: (559) 227-1663 |
NPI Number | 1629108824 |
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Provider Enumeration Date | 03/06/2007 |
Last Update Date | 09/13/2011 |
Medicare PECOS PAC ID | 6406959055 |
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Medicare Enrollment ID | O20070320000205 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629108824 | NPI | - | NPPES |
5430437 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | C52080 (California) | Primary |
Provider Name | Antonio Villalvazo |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689772261 PECOS PAC ID: 1153424700 Enrollment ID: I20070320000198 |
Fresno Healthcare Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3233 N Chestnut Ave Ste 102, Fresno, CA 93726 Phone: 559-456-1167 Fax: 559-456-1183 | |
Planned Parenthood Mar Monte, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6095 N 1st St, Fresno, CA 93710 Phone: 559-446-1515 Fax: 559-446-1273 | |
United Health Centers Of The San Joaquin Valley Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2630 Tuolumne St, Fresno, CA 93721 Phone: 800-492-4227 Fax: 559-646-6614 |