Healthcare Provider Details

I. General information

NPI: 1649151457
Provider Name (Legal Business Name): ALOHA TMS A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W BULLARD AVE STE 105
CLOVIS CA
93612-0998
US

IV. Provider business mailing address

180 W BULLARD AVE STE 105
CLOVIS CA
93612-0998
US

V. Phone/Fax

Practice location:
  • Phone: 559-203-3775
  • Fax:
Mailing address:
  • Phone: 559-203-3775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. NANTHANAEL LACLE
Title or Position: COO
Credential:
Phone: 559-905-4220