Healthcare Provider Details

I. General information

NPI: 1093747396
Provider Name (Legal Business Name): THOMAS SCHRAM ENLOE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 W LACEY BLVD
HANFORD CA
93230-4342
US

IV. Provider business mailing address

460 GREENFIELD AVE SUITE 1
HANFORD CA
93230-3500
US

V. Phone/Fax

Practice location:
  • Phone: 559-582-1041
  • Fax: 559-582-4829
Mailing address:
  • Phone: 559-582-0141
  • Fax: 559-582-4829

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG36115
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: