| North Fresno Primary Care Inc | |
|
1805 E Fir Ave Fresno CA 93720-3859 | |
| (559) 908-5906 | |
| (559) 445-0316 |
| Full Name | North Fresno Primary Care Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1805 E Fir Ave, Fresno, California |
| Authorized Official Name and Position | Alberto Ruvalcaba (MD/OWNER) |
| Authorized Official Contact | 5599085906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Fresno Primary Care Inc 1805 E Fir Ave Fresno CA 93720-3859 Ph: (559) 908-5906 | North Fresno Primary Care Inc 1805 E Fir Ave Fresno CA 93720-3859 Ph: (559) 908-5906 |
| NPI Number | 1245527357 |
|---|---|
| Provider Enumeration Date | 07/09/2011 |
| Last Update Date | 07/09/2011 |
| Medicare PECOS PAC ID | 1658545009 |
|---|---|
| Medicare Enrollment ID | O20111121000376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245527357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A112939 (California) | Primary |
| Provider Name | Jose L Bautista |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134119308 PECOS PAC ID: 8022928233 Enrollment ID: I20080117000544 |
| Provider Name | Juan G Bautista |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1164713194 PECOS PAC ID: 4789820192 Enrollment ID: I20130409000290 |
| Provider Name | Melanie Kay Selsor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275001026 PECOS PAC ID: 0648519652 Enrollment ID: I20190307003404 |
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