Healthcare Provider Details
I. General information
NPI: 1346263225
Provider Name (Legal Business Name): JEANETTE CSERNA-KINION MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/25/2006
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5479 N FRESNO ST STE 100
FRESNO CA
93710-8328
US
IV. Provider business mailing address
5479 N FRESNO ST STE 100
FRESNO CA
93710-8328
US
V. Phone/Fax
- Phone: 559-439-1832
- Fax: 559-439-6843
- Phone: 559-439-1832
- Fax: 559-439-6843
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A39950 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: