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General NPI Number Information
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NPI Number | 1043081821
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Entity Type | Organization
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Legal Business Name | 4KIDS URGENT CARE MEDICAL CENTER, INC
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Dates
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Enumeration Date | 01/11/2024
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Last Update Date | 01/11/2024
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Provider Practice Location Address
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Address Line | 3727 N 1ST STE 106
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City | FRESNO
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State | CA
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Zip | 93726-5628
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Country | US
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Telephone | 559-890-6111
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Fax | 559-892-0327
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Provider Business Mailing Address
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Address Line | 3727 N 1ST STE 106
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City | FRESNO
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State | CA
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Zip | 93726-5628
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Country | US
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Telephone | 559-890-6111
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Fax | 559-892-0327
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Authorized Official
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Title or Position | PRESIDENT
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Name | TOU CHOUA VANG
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Credential | M.D.
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Telephone | 559-990-9219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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