Healthcare Provider Details

I. General information

NPI: 1568784098
Provider Name (Legal Business Name): SUMEER THINDA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2010
Last Update Date: 09/28/2020
Certification Date: 09/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 E HERNDON AVE STE 301
FRESNO CA
93720-3326
US

IV. Provider business mailing address

1360 E HERNDON AVE STE 301
FRESNO CA
93720-3326
US

V. Phone/Fax

Practice location:
  • Phone: 559-486-5000
  • Fax: 559-439-6804
Mailing address:
  • Phone: 559-486-5000
  • Fax: 559-439-6804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA125632
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: