Healthcare Provider Details

I. General information

NPI: 1285664243
Provider Name (Legal Business Name): CARLOS MANUEL JUAREZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1381 E HERNDON AVE STE 104
FRESNO CA
93720-3307
US

IV. Provider business mailing address

2151 HERNDON AVE STE 102
CLOVIS CA
93611-6307
US

V. Phone/Fax

Practice location:
  • Phone: 559-432-3434
  • Fax:
Mailing address:
  • Phone: 559-432-3434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG73601
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberG73601
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: