Healthcare Provider Details

I. General information

NPI: 1750737953
Provider Name (Legal Business Name): CALIFORNIA INTEGRATIVE HEALTHCARE A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1180 E SHAW AVE STE 101
FRESNO CA
93710-7812
US

IV. Provider business mailing address

373 E SHAW AVE STE 332
FRESNO CA
93710-7609
US

V. Phone/Fax

Practice location:
  • Phone: 559-389-0622
  • Fax: 559-389-7809
Mailing address:
  • Phone: 559-389-0622
  • Fax: 559-389-0763

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SONAL PATEL
Title or Position: OWNER
Credential: ND
Phone: 559-455-4707