Healthcare Provider Details

I. General information

NPI: 1073153250
Provider Name (Legal Business Name): CALIFORNIA TELEMEDICINE ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2020
Last Update Date: 11/29/2021
Certification Date: 11/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7111 N FRESNO ST
FRESNO CA
93720-2965
US

IV. Provider business mailing address

7111 N FRESNO ST STE 200
FRESNO CA
93720-2959
US

V. Phone/Fax

Practice location:
  • Phone: 800-882-5484
  • Fax:
Mailing address:
  • Phone: 800-882-5484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARK SHEN
Title or Position: PRESIDENT
Credential: MD
Phone: 800-475-6168