Healthcare Provider Details
I. General information
NPI: 1437602919
Provider Name (Legal Business Name): THE WHITE MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/01/2016
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7050 N RECREATION AVE
FRESNO CA
93720-8001
US
IV. Provider business mailing address
PO BOX 1368
CLOVIS CA
93613-1368
US
V. Phone/Fax
- Phone: 559-777-2956
- Fax: 559-831-3220
- Phone: 559-777-2956
- Fax: 559-831-3220
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VF0040X |
| Taxonomy | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
A
WHITE
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 559-777-2956