Healthcare Provider Details

I. General information

NPI: 1588659049
Provider Name (Legal Business Name): JAMES LEE MINTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 02/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 HERNDON AVE STE. 101
CLOVIS CA
93611-6101
US

IV. Provider business mailing address

7471 N FRESNO ST
FRESNO CA
93720-2457
US

V. Phone/Fax

Practice location:
  • Phone: 559-797-4315
  • Fax:
Mailing address:
  • Phone: 559-436-4500
  • Fax: 559-436-0500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG42221
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: