Healthcare Provider Details

I. General information

NPI: 1710044284
Provider Name (Legal Business Name): CANCER IMAGING ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 EAST FIR AVENUE
FRESNO CA
93720
US

IV. Provider business mailing address

PO BOX 25042
FRESNO CA
93729-5042
US

V. Phone/Fax

Practice location:
  • Phone: 559-326-1222
  • Fax:
Mailing address:
  • Phone: 559-438-1245
  • Fax: 559-261-2968

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: CLAY STEVENS
Title or Position: CEO
Credential:
Phone: 559-438-1245