Healthcare Provider Details

I. General information

NPI: 1316901663
Provider Name (Legal Business Name): GIATRI DAVE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/19/2023
Certification Date: 07/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7887 N CEDAR AVE
FRESNO CA
93720-2685
US

IV. Provider business mailing address

PO BOX 756
DANVILLE CA
94526-0756
US

V. Phone/Fax

Practice location:
  • Phone: 209-543-0684
  • Fax: 209-343-3809
Mailing address:
  • Phone: 209-543-0684
  • Fax: 209-343-3809

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberA69760
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: