Healthcare Provider Details

I. General information

NPI: 1528798709
Provider Name (Legal Business Name): TRUMEDICAL CARE A PHYSICIAN ASSISTANT HEALTHCARE PARTNER CORPO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2022
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W HERNDON AVE
CLOVIS CA
93612-0381
US

IV. Provider business mailing address

255 W HERNDON AVE
CLOVIS CA
93612-0381
US

V. Phone/Fax

Practice location:
  • Phone: 559-477-9889
  • Fax:
Mailing address:
  • Phone: 559-550-6226
  • 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: DAVID PENA
Title or Position: CEO
Credential: PA
Phone: 559-550-6226