Healthcare Provider Details

I. General information

NPI: 1518180298
Provider Name (Legal Business Name): SUCHAT JARIANGPRASERT M.D.,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2936 N FRESNO ST
FRESNO CA
93703-1123
US

IV. Provider business mailing address

2936 N FRESNO ST
FRESNO CA
93703-1123
US

V. Phone/Fax

Practice location:
  • Phone: 559-225-7670
  • Fax: 559-225-7670
Mailing address:
  • Phone: 559-225-7670
  • Fax: 559-225-7670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA38158
License Number StateCA

VIII. Authorized Official

Name: DR. SUCHAT JARIANGPRASERT
Title or Position: OWNER
Credential: M.D.
Phone: 559-225-7670