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NPI 1043513526

NPI 1043513526 : AMOR FERNANDO MD INC : FRESNO, CA

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General NPI Number Information
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    NPI Number           |    1043513526
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    Entity Type          |    Organization 
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    Legal Business Name  |    AMOR FERNANDO MD INC 
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Dates
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    Enumeration Date     |    12/06/2010
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    Last Update Date     |    12/06/2010
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Provider Practice Location Address
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    Address Line         |    3766 N 1ST ST 
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    City                 |    FRESNO
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    State                |    CA
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    Zip                  |    93726-5601
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    Country              |    US
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    Telephone            |    559-227-3151
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    Fax                  |    559-227-0210
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Provider Business Mailing Address
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    Address Line         |    3766 N 1ST ST 
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    City                 |    FRESNO
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    State                |    CA
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    Zip                  |    93726-5601
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    Country              |    US
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    Telephone            |    559-227-3151
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    Fax                  |    559-227-0210
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Authorized Official
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    Title or Position    |    PRESIDENT/CEO
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    Name                 |    DR. AMOR  FERNANDO 
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    Credential           |    MD
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    Telephone            |    559-227-3151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208D00000X
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    Taxonomy Name        |    General Practice Physician
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    License Number       |    A39704
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    License Number State |    CA
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