Healthcare Provider Details

I. General information

NPI: 1174529135
Provider Name (Legal Business Name): MARTIN ARTHUR RINDAHL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2005
Last Update Date: 10/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 W FIR AVE
CLOVIS CA
93611-0220
US

IV. Provider business mailing address

1867 E FIR AVE STE 104
FRESNO CA
93720-3808
US

V. Phone/Fax

Practice location:
  • Phone: 559-297-0300
  • Fax: 559-323-5461
Mailing address:
  • Phone: 559-297-0300
  • Fax: 559-323-5461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberG69216
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: