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General NPI Number Information
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NPI Number | 1134078751
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Entity Type | Organization
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Legal Business Name | 9163 LLC
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 4080 N BLACKSTONE AVE
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City | FRESNO
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State | CA
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Zip | 93726-3805
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Country | US
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Telephone | 559-270-5813
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Fax |
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Provider Business Mailing Address
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Address Line | 4721 W JENNIFER AVE STE 11
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City | FRESNO
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State | CA
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Zip | 93722-6499
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Country | US
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Telephone | 559-270-5813
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Fax |
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. JATIN PATEL
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Credential | BA
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Telephone | 559-270-5813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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