Healthcare Provider Details

I. General information

NPI: 1225973639
Provider Name (Legal Business Name): EMBERCARE, A MEDICAL PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6121 N THESTA ST STE 115B
FRESNO CA
93710-5294
US

IV. Provider business mailing address

2203 E CARNOUSTIE AVE
FRESNO CA
93730-5153
US

V. Phone/Fax

Practice location:
  • Phone: 615-423-9545
  • Fax:
Mailing address:
  • Phone: 615-423-9545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JIAKUN WANG
Title or Position: CEO
Credential: M.D.
Phone: 615-423-9545