Healthcare Provider Details

I. General information

NPI: 1902470388
Provider Name (Legal Business Name): CHRISTOPHER JAMES MCADAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2021
Last Update Date: 05/24/2021
Certification Date: 05/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3636 N 1ST ST STE 112&124
FRESNO CA
93726-6800
US

IV. Provider business mailing address

3636 N 1ST ST STE 112&124
FRESNO CA
93726-6800
US

V. Phone/Fax

Practice location:
  • Phone: 559-476-2177
  • Fax:
Mailing address:
  • Phone: 559-476-2177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number702434
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: