Healthcare Provider Details

I. General information

NPI: 1528847530
Provider Name (Legal Business Name): TIGER FONG SAELEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2023
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 W SHAW AVE STE 126
FRESNO CA
93711-3400
US

IV. Provider business mailing address

2350 W SHAW AVE STE 126
FRESNO CA
93711-3400
US

V. Phone/Fax

Practice location:
  • Phone: 209-294-8285
  • Fax:
Mailing address:
  • Phone: 209-294-8285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number88220
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: