| Family Care Clinic Of Fresno | |
|
6191 N Fresno St Suite 101 Fresno CA 93710-8612 | |
| (559) 227-1663 | |
| (559) 227-9083 |
| Full Name | Family Care Clinic Of Fresno |
|---|---|
| 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 |
|---|---|
| Family Care Clinic Of Fresno 6191 N Fresno St Suite 101 Fresno CA 93710-8612 Ph: (559) 227-1663 | Family Care Clinic Of Fresno 6191 N Fresno St Suite 101 Fresno CA 93710-8612 Ph: (559) 227-1663 |
| NPI Number | 1629108824 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 09/13/2011 |
| Medicare PECOS PAC ID | 6406959055 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689772261 PECOS PAC ID: 1153424700 Enrollment ID: I20070320000198 |
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