Healthcare Provider Details

I. General information

NPI: 1558396069
Provider Name (Legal Business Name): DR. DEVANG PRAJAPATI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2823 FRESNO ST
FRESNO CA
93721-1324
US

IV. Provider business mailing address

7300 N FRESNO ST
FRESNO CA
93720-2941
US

V. Phone/Fax

Practice location:
  • Phone: 559-459-3821
  • Fax: 559-459-3887
Mailing address:
  • Phone: 559-375-0782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA78056
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: