Healthcare Provider Details

I. General information

NPI: 1659303832
Provider Name (Legal Business Name): PRIMARY CARE CONSULTANTS, INC. A MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 04/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W BULLARD AVE SUITE 124
CLOVIS CA
93612-0861
US

IV. Provider business mailing address

255 W BULLARD AVE SUITE 124
CLOVIS CA
93612-0861
US

V. Phone/Fax

Practice location:
  • Phone: 559-297-1300
  • Fax: 559-324-7534
Mailing address:
  • Phone: 559-297-1300
  • Fax: 559-322-9161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN A BARON
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 559-297-1322