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General NPI Number Information
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NPI Number | 1144282831
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Entity Type | Organization
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Legal Business Name | FOGG REMINGTON EYECARE, INC.
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 3830 N 1ST ST
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City | FRESNO
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State | CA
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Zip | 93726-4301
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Country | US
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Telephone | 559-226-3970
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Fax | 559-241-0368
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Provider Business Mailing Address
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Address Line | 1360 E HERNDON AVE SUITE 401
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City | FRESNO
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State | CA
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Zip | 93720-3326
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Country | US
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Telephone | 559-449-5010
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Fax | 559-449-5014
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Authorized Official
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Title or Position | CREDENTIALING
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Name | MS. PAULA PENDLEY
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Credential |
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Telephone | 559-449-5011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State | CA
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