Healthcare Provider Details

I. General information

NPI: 1447280722
Provider Name (Legal Business Name): PACIFIC FAMILY HEALTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 W SHAW AVE STE 102 3475 W SHAW AVE STE 102
FRESNO CA
93711-3200
US

IV. Provider business mailing address

3475 W SHAW AVE STE 102 3475 W SHAW AVE STE 102
FRESNO CA
93711-3200
US

V. Phone/Fax

Practice location:
  • Phone: 559-252-1932
  • Fax: 559-456-3070
Mailing address:
  • Phone: 559-252-1932
  • Fax: 559-456-3070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateCA

VIII. Authorized Official

Name: PEDRO VASQUEZ GARCIA
Title or Position: CEO
Credential: NONE
Phone: 559-252-1932