MEDICARE: MRS. HA TI BICH HOANG NISHIHARA N.P.

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	363L00000X	Nurse Practitioner	10727	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649284993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HA TI BICH HOANG NISHIHARA N.P.

Provider Business Mailing Address
First Line	:	PO BOX 25880
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-5880
Country	:	US
Telephone Number	:	559-431-8900
Fax Number	:	559-431-4367

Provider Business Practice Location Address
First Line	:	3636 N 1ST ST STE 165
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93726-6818
Country	:	US
Telephone Number	:	559-225-2000
Fax Number	:	559-226-5761

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	07/08/2007

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