Healthcare Provider Details

I. General information

NPI: 1083636138
Provider Name (Legal Business Name): DORIS W GORDY P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7471 N FRESNO ST
FRESNO CA
93720-2457
US

IV. Provider business mailing address

1360 BAILEY ST
HANFORD CA
93230-5921
US

V. Phone/Fax

Practice location:
  • Phone: 559-436-4500
  • Fax: 559-261-1526
Mailing address:
  • Phone: 559-584-6499
  • Fax: 559-584-8124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: