Healthcare Provider Details

I. General information

NPI: 1093104457
Provider Name (Legal Business Name): TALAL M ARAB M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2015
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 E HERNDON AVE
FRESNO CA
93720-3309
US

IV. Provider business mailing address

1303 E HERNDON AVE STE 850
FRESNO CA
93720-3309
US

V. Phone/Fax

Practice location:
  • Phone: 559-450-3000
  • Fax:
Mailing address:
  • Phone: 559-450-5611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA170124
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberA170124
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberA170124
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: