Fresno Family Medical Clinic | |
3121 E Olive Ave Fresno CA 93702-1030 | |
(559) 412-4927 | |
(559) 493-5028 |
Full Name | Fresno Family Medical Clinic |
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Speciality | Clinic/Center |
Location | 3121 E Olive Ave, Fresno, California |
Authorized Official Name and Position | Hipolito Gallardo Mariano (PRESIDENT) |
Authorized Official Contact | 5594124927 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Fresno Family Medical Clinic 3121 E Olive Ave Fresno CA 93702-1030 Ph: (559) 412-4927 | Fresno Family Medical Clinic 3121 E Olive Ave Fresno CA 93702-1030 Ph: (559) 412-4927 |
NPI Number | 1144451659 |
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Provider Enumeration Date | 07/31/2009 |
Last Update Date | 04/18/2016 |
Medicare PECOS PAC ID | 9335270206 |
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Medicare Enrollment ID | O20100622000427 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144451659 | NPI | - | NPPES |
00A889030 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | A88903 (California) | Primary |
Provider Name | Hipolito G Mariano |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1376685685 PECOS PAC ID: 2062503337 Enrollment ID: I20070801000612 |
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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 |