Healthcare Provider Details

I. General information

NPI: 1932181724
Provider Name (Legal Business Name): GARY L ARENDS JR. DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 03/07/2023
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL # FE10
MADERA CA
93636-8761
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL # FE10
MADERA CA
93636-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-5941
  • Fax: 559-353-5945
Mailing address:
  • Phone: 559-353-5941
  • Fax: 559-353-5945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number20A8430
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: