Healthcare Provider Details

I. General information

NPI: 1245168566
Provider Name (Legal Business Name): CLOVIS PEDIATRIC GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/08/2026
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

726 N MEDICAL CENTER DR E
CLOVIS CA
93611-6881
US

IV. Provider business mailing address

726 N MEDICAL CENTER DR E
CLOVIS CA
93611-6881
US

V. Phone/Fax

Practice location:
  • Phone: 559-900-3045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MANDEEP DHILLON
Title or Position: NP
Credential: FNP-C
Phone: 559-900-3045