Healthcare Provider Details

I. General information

NPI: 1326591041
Provider Name (Legal Business Name): FERNANDO KAMALEI CRUZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 N MAGNOLIA AVE STE 100
CLOVIS CA
93611-9205
US

IV. Provider business mailing address

2625 E DIVISADERO ST
FRESNO CA
93721-1431
US

V. Phone/Fax

Practice location:
  • Phone: 559-320-0531
  • Fax: 559-320-0539
Mailing address:
  • Phone: 559-443-2682
  • Fax: 559-443-2681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA163889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: