Healthcare Provider Details

I. General information

NPI: 1013235605
Provider Name (Legal Business Name): FEEI FEEI UNG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2010
Last Update Date: 03/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 SHAW AVE
CLOVIS CA
93611-4028
US

IV. Provider business mailing address

1530 SHAW AVE
CLOVIS CA
93611-4028
US

V. Phone/Fax

Practice location:
  • Phone: 559-323-9133
  • Fax:
Mailing address:
  • Phone: 559-323-9133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA112193
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: