| Fresno Women's Medical Group, Inc. | |
|
726 N. Medical Center Drive East Suite 221 Clovis CA 93611-6886 | |
| (559) 322-2900 | |
| (559) 324-8793 |
| Full Name | Fresno Women's Medical Group, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 726 N. Medical Center Drive East, Clovis, California |
| Authorized Official Name and Position | Sharon Monica Kopacz (PHYSICIAN-SOLE OWNER) |
| Authorized Official Contact | 5593222900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fresno Women's Medical Group, Inc. 726 N. Medical Center Drive East Suite 221 Clovis CA 93611-6886 Ph: (559) 322-2900 | Fresno Women's Medical Group, Inc. 726 N. Medical Center Drive East Suite 221 Clovis CA 93611-6886 Ph: (559) 322-2900 |
| NPI Number | 1992710552 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 06/08/2023 |
| Medicare PECOS PAC ID | 0648164889 |
|---|---|
| Medicare Enrollment ID | O20040210000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992710552 | NPI | - | NPPES |
| 1750703237 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Kelli R Beingesser |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730144528 PECOS PAC ID: 6507750759 Enrollment ID: I20050823000866 |
| Provider Name | Sharon M Kopacz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952552333 PECOS PAC ID: 9537313416 Enrollment ID: I20130130000094 |
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