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General NPI Number Information
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NPI Number | 1073908158
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Entity Type | Organization
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Legal Business Name | VANG CHILDREN'S URGENT CARE, INC.
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Dates
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Enumeration Date | 04/06/2015
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 4615 N 1ST ST
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City | FRESNO
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State | CA
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Zip | 93726-0904
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Country | US
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Telephone | 209-276-7166
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Fax |
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Provider Business Mailing Address
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Address Line | 4615 N 1ST ST
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City | FRESNO
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State | CA
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Zip | 93726-0904
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Country | US
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Telephone | 209-276-7166
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Fax |
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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 | MD
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Telephone | 559-999-5420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | A83557
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | A83557
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License Number State | CA
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