Healthcare Provider Details

I. General information

NPI: 1790743151
Provider Name (Legal Business Name): ROBERT GARIBAY FERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 W CYPRESS AVE
REEDLEY CA
93654-2113
US

IV. Provider business mailing address

1479 W LACEY BLVD
HANFORD CA
93230-5906
US

V. Phone/Fax

Practice location:
  • Phone: 559-643-8083
  • Fax: 559-643-8057
Mailing address:
  • Phone: 559-583-4617
  • Fax: 559-583-4625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A7121
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: