Healthcare Provider Details

I. General information

NPI: 1831582220
Provider Name (Legal Business Name): KMY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2015
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6079 N FRESNO ST STE 103
FRESNO CA
93710-5276
US

IV. Provider business mailing address

6079 N FRESNO ST STE 103
FRESNO CA
93710-5276
US

V. Phone/Fax

Practice location:
  • Phone: 559-277-3909
  • Fax: 559-277-3090
Mailing address:
  • Phone: 559-277-3909
  • Fax: 559-277-3090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224P00000X
TaxonomyProsthetist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberC50916
License Number StateMD

VIII. Authorized Official

Name: MUHAMMAD SALMAN UL-HAQ
Title or Position: CEO
Credential:
Phone: 559-277-3909