Healthcare Provider Details

I. General information

NPI: 1326254624
Provider Name (Legal Business Name): PAUL A WHITE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7050 N RECREATION AVE STE 103
FRESNO CA
93720-8001
US

IV. Provider business mailing address

PO BOX 1368
CLOVIS CA
93613-1368
US

V. Phone/Fax

Practice location:
  • Phone: 559-493-5307
  • Fax: 559-553-2629
Mailing address:
  • Phone: 559-777-2956
  • Fax: 559-831-3220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License NumberA99179
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA99179
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: