Healthcare Provider Details
I. General information
NPI: 1861207862
Provider Name (Legal Business Name): ENT ASSOCIATES OF FRESNO INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2025
Last Update Date: 08/09/2025
Certification Date: 08/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
540 E HERNDON AVE STE 102
FRESNO CA
93720-2993
US
IV. Provider business mailing address
7726 N 1ST ST # 344
FRESNO CA
93720-0989
US
V. Phone/Fax
- Phone: 805-717-0726
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207YX0901X |
| Taxonomy | Otology & Neurotology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOHN
KERR
Title or Position: CFO
Credential: DO
Phone: 559-768-3682