Healthcare Provider Details

I. General information

NPI: 1164500070
Provider Name (Legal Business Name): SURESH K. JOISHY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 N FRESNO ST
FRESNO CA
93720-2941
US

IV. Provider business mailing address

1800 HARRISON ST FL 7
OAKLAND CA
94612-3429
US

V. Phone/Fax

Practice location:
  • Phone: 559-448-4500
  • Fax:
Mailing address:
  • Phone: 510-625-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberC50191
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberMD-18218
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: