Healthcare Provider Details

I. General information

NPI: 1629382213
Provider Name (Legal Business Name): AMIE ELIZABETH HOLMES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMIE ELIZABETH HUFF MD

II. Dates (important events)

Enumeration Date: 08/06/2010
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 W. HERNDON AVE
CLOVIS CA
93612
US

IV. Provider business mailing address

P.O. BOX 28946
FRESNO CA
93729
US

V. Phone/Fax

Practice location:
  • Phone: 559-324-3833
  • Fax: 559-324-3834
Mailing address:
  • Phone: 559-228-4425
  • Fax: 559-228-4424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA129969
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: