Healthcare Provider Details

I. General information

NPI: 1053758607
Provider Name (Legal Business Name): ELAINE WINIFRED MORRIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2013
Last Update Date: 05/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1752 W CALIMYRNA AVE APT B
FRESNO CA
93711-1871
US

IV. Provider business mailing address

1752 W CALIMYRNA AVE APT B
FRESNO CA
93711-1871
US

V. Phone/Fax

Practice location:
  • Phone: 559-451-0721
  • Fax:
Mailing address:
  • Phone: 559-451-0721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG36105
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: