Healthcare Provider Details

I. General information

NPI: 1922296789
Provider Name (Legal Business Name): MARK A PINTO, MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 09/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 E BULLARD AVE SUITE 105
FRESNO CA
93710-5474
US

IV. Provider business mailing address

728 E BULLARD AVE SUITE 105
FRESNO CA
93710-5474
US

V. Phone/Fax

Practice location:
  • Phone: 559-313-6877
  • Fax: 559-478-8136
Mailing address:
  • Phone: 559-313-6877
  • Fax: 559-478-8136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA70500
License Number StateCA

VIII. Authorized Official

Name: DR. MARK ANTHONY PINTO
Title or Position: PHYSICIAN
Credential: MD
Phone: 559-313-6877