Healthcare Provider Details

I. General information

NPI: 1124342753
Provider Name (Legal Business Name): LUC ARNAUD HIBBS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2010
Last Update Date: 03/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 N FRESNO ST
FRESNO CA
93701-2302
US

IV. Provider business mailing address

2525 N ARTHUR AVE
FRESNO CA
93705-4615
US

V. Phone/Fax

Practice location:
  • Phone: 559-499-6440
  • Fax:
Mailing address:
  • Phone: 801-244-4596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA110642
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: