Healthcare Provider Details

I. General information

NPI: 1396044061
Provider Name (Legal Business Name): WILLIAM M. RICH, M.D., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2011
Last Update Date: 03/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6323 N FRESNO ST STE. 105
FRESNO CA
93710-5282
US

IV. Provider business mailing address

6323 N FRESNO ST STE. 105
FRESNO CA
93710-5282
US

V. Phone/Fax

Practice location:
  • Phone: 559-433-0335
  • Fax:
Mailing address:
  • Phone: 559-433-0335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberG28911
License Number StateCA

VIII. Authorized Official

Name: DR. WILLIAM M. RICH
Title or Position: PRESIDENT
Credential: M.D.
Phone: 559-433-0335