Healthcare Provider Details

I. General information

NPI: 1548457245
Provider Name (Legal Business Name): RICHARD S. DEMERA, M.D. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2007
Last Update Date: 08/25/2022
Certification Date: 08/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 E HERNDON AVE STE 101
FRESNO CA
93720-2993
US

IV. Provider business mailing address

540 E HERNDON AVE STE 101
FRESNO CA
93720-2993
US

V. Phone/Fax

Practice location:
  • Phone: 559-431-0340
  • Fax: 559-431-0301
Mailing address:
  • Phone: 559-431-0340
  • Fax: 559-431-0301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0012X
TaxonomySleep Medicine (Otolaryngology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHARD SAMUEL DEMERA
Title or Position: OWNER/PRESIDENT
Credential: M.D.
Phone: 559-903-4194