Healthcare Provider Details

I. General information

NPI: 1205837192
Provider Name (Legal Business Name): HAROLD FELIX GROOMS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1187 E HERNDON AVE #106
FRESNO CA
93720-3166
US

IV. Provider business mailing address

3812 N 1ST ST
FRESNO CA
93726-4301
US

V. Phone/Fax

Practice location:
  • Phone: 559-224-0900
  • Fax: 559-224-9009
Mailing address:
  • Phone: 559-495-3120
  • Fax: 559-495-3134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG36121
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: