Healthcare Provider Details

I. General information

NPI: 1740326891
Provider Name (Legal Business Name): MICHAEL J SINOPOLI PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4910 E CLINTON WAY STE 101
FRESNO CA
93727-1560
US

IV. Provider business mailing address

1235 W DAYTON AVE
FRESNO CA
93705-3428
US

V. Phone/Fax

Practice location:
  • Phone: 559-453-5203
  • Fax: 559-453-3321
Mailing address:
  • Phone: 559-225-3738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA17642
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: