Healthcare Provider Details
I. General information
NPI: 1770917064
Provider Name (Legal Business Name): NICHOLAS ORME M.D.,INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2013
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6183 N FRESNO ST STE 101
FRESNO CA
93710-8611
US
IV. Provider business mailing address
6183 N FRESNO ST STE 101
FRESNO CA
93710-8611
US
V. Phone/Fax
- Phone: 559-432-5003
- Fax: 559-432-5008
- Phone: 559-432-5003
- Fax: 559-432-5008
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305R00000X |
| Taxonomy | Preferred Provider Organization |
| License Number | G63574 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
NICHOLAS
ORME
Title or Position: PRESIDENT
Credential: M.D
Phone: 559-432-5003