Healthcare Provider Details

I. General information

NPI: 1093649741
Provider Name (Legal Business Name): ADVANCED SPECIALTY CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6323 N FRESNO ST STE 105
FRESNO CA
93710-5282
US

IV. Provider business mailing address

6323 N FRESNO ST STE 105
FRESNO CA
93710-5282
US

V. Phone/Fax

Practice location:
  • Phone: 559-785-1310
  • Fax: 559-785-1335
Mailing address:
  • Phone: 559-785-1310
  • Fax: 559-785-1335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: KHOI LE
Title or Position: OWNER
Credential: MD
Phone: 559-785-1310