Healthcare Provider Details

I. General information

NPI: 1750710034
Provider Name (Legal Business Name): EYE MEDICAL CLINIC OF FRESNO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 E HERNDON AVE SUITE 301
FRESNO CA
93720-3326
US

IV. Provider business mailing address

1360 E HERNDON AVE SUITE 301
FRESNO CA
93720-3326
US

V. Phone/Fax

Practice location:
  • Phone: 559-486-5000
  • Fax:
Mailing address:
  • Phone: 559-486-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD NOEL MENDOZA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 559-486-5000