MEDICARE: FRESNO CA MULTI ASC LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center		CA

General Provider Information

NPI Number	:	1538403670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRESNO CA MULTI ASC LP

Provider Business Mailing Address
First Line	:	1A BURTON HILLS BLVD
Second Line	:	SUITE 500
City	:	NASHVILLE
State	:	TN
Zip	:	37215-0000
Country	:	US
Telephone Number	:	615-240-3820
Fax Number	:	615-234-1720

Provider Business Practice Location Address
First Line	:	1843 E FIR AVE
Second Line	:	SUITE 104
City	:	FRESNO
State	:	CA
Zip	:	93720-3863
Country	:	US
Telephone Number	:	559-323-6611
Fax Number	:	559-323-5322

Authorized Official
Title or Position	:	PRESIDENT OF LP
Name	:	MS. BILLIE A. PAYNE
Credential	:
Telephone Number	:	615-665-1283

Provider Enumeration Date	:	11/15/2012
Last Update Date	:	09/07/2023

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