Healthcare Provider Details

I. General information

NPI: 1396828588
Provider Name (Legal Business Name): LUCIO MANLIO NOBILE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 N FRESNO -PALM 3
FRESNO CA
93720-9372
US

IV. Provider business mailing address

6121 N THESTA ST STE 204
FRESNO CA
93710-5294
US

V. Phone/Fax

Practice location:
  • Phone: 559-448-5524
  • Fax:
Mailing address:
  • Phone: 559-650-4831
  • Fax: 559-650-4790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA81546
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberA81546
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: