Healthcare Provider Details

I. General information

NPI: 1043081821
Provider Name (Legal Business Name): 4KIDS URGENT CARE MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 01/11/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 N 1ST STE 106
FRESNO CA
93726-5628
US

IV. Provider business mailing address

3727 N 1ST STE 106
FRESNO CA
93726-5628
US

V. Phone/Fax

Practice location:
  • Phone: 559-890-6111
  • Fax: 559-892-0327
Mailing address:
  • Phone: 559-890-6111
  • Fax: 559-892-0327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: TOU CHOUA VANG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 559-990-9219