Healthcare Provider Details
I. General information
NPI: 1891770814
Provider Name (Legal Business Name): REGIONAL HAND CENTER OF CENTRAL CALIFORNIA, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2005
Last Update Date: 07/27/2021
Certification Date: 07/27/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2139 E BEECHWOOD AVE
FRESNO CA
93720
US
IV. Provider business mailing address
2139 E BEECHWOOD AVE
FRESNO CA
93720
US
V. Phone/Fax
- Phone: 559-322-6600
- Fax: 559-322-4625
- Phone: 559-322-6600
- Fax: 559-322-4625
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | CA |
VIII. Authorized Official
Name:
KEVIN
ROBERT
LOPEZ
Title or Position: CIO
Credential:
Phone: 559-322-6600