Healthcare Provider Details

I. General information

NPI: 1629412259
Provider Name (Legal Business Name): LUIS ALBERTO DEHESA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2013
Last Update Date: 02/22/2026
Certification Date: 02/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

978 N TEMPERANCE AVE
CLOVIS CA
93611-8606
US

IV. Provider business mailing address

978 N TEMPERANCE AVE
CLOVIS CA
93611-8606
US

V. Phone/Fax

Practice location:
  • Phone: 559-951-9000
  • Fax: 559-234-6334
Mailing address:
  • Phone: 559-951-9000
  • Fax: 559-234-6334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberA142134
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: