Healthcare Provider Details

I. General information

NPI: 1699946483
Provider Name (Legal Business Name): ANA ALICIA MCGILL RHNP & RN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANA ALICIA TIRADO RHNP & RN

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 03/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5727 N FRESNO ST STE 101
FRESNO CA
93710-6000
US

IV. Provider business mailing address

1691 THE ALAMEDA
SAN JOSE CA
95126-2203
US

V. Phone/Fax

Practice location:
  • Phone: 559-446-1515
  • Fax: 559-446-1273
Mailing address:
  • Phone: 408-287-7532
  • Fax: 408-287-0405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP6387
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberNP 6387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: