Healthcare Provider Details

I. General information

NPI: 1902946544
Provider Name (Legal Business Name): CHARLES J. HELLER, MD. INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7033 N FRESNO ST SUITE 201
FRESNO CA
93720-2976
US

IV. Provider business mailing address

7033 N FRESNO ST SUITE 201
FRESNO CA
93720-2976
US

V. Phone/Fax

Practice location:
  • Phone: 559-435-5581
  • Fax: 559-435-5583
Mailing address:
  • Phone: 559-435-5581
  • Fax: 559-435-5583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License NumberC19991
License Number StateCA

VIII. Authorized Official

Name: MR. RIDGE ANDREWS
Title or Position: CEO
Credential:
Phone: 559-435-5581