Healthcare Provider Details

I. General information

NPI: 1417406117
Provider Name (Legal Business Name): CAPITAL CONSULTING SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2016
Last Update Date: 09/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 W SHAW AVE SUITE 103
FRESNO CA
93711-9998
US

IV. Provider business mailing address

2350 W SHAW AVE SUITE 103
FRESNO CA
93711-9998
US

V. Phone/Fax

Practice location:
  • Phone: 213-400-0022
  • Fax: 559-570-0117
Mailing address:
  • Phone: 213-400-0022
  • Fax: 559-570-0117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number State

VIII. Authorized Official

Name: GEVORK GEORGE YARALYAN
Title or Position: CEO
Credential: MSW
Phone: 213-400-0022