Healthcare Provider Details

I. General information

NPI: 1376672048
Provider Name (Legal Business Name): CENTRAL CALIFORNIA WOMENS HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 09/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 FULTON ST STE 102
FRESNO CA
93721-1093
US

IV. Provider business mailing address

1929 FULTON ST STE 102
FRESNO CA
93721-1093
US

V. Phone/Fax

Practice location:
  • Phone: 559-400-6270
  • Fax: 888-323-0590
Mailing address:
  • Phone: 559-400-6270
  • Fax: 888-323-0590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: MR. DUANE OSWALD
Title or Position: CEO
Credential:
Phone: 559-261-9060