=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245511922
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCISCO ROBLEDO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/08/2011
-----------------------------------------------------
Last Update Date | 09/08/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1328 E RED BEAUT CIR
-----------------------------------------------------
City | REEDLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93654-4064
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-333-0956
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1328 E RED BEAUT CIR
-----------------------------------------------------
City | REEDLEY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93654-4064
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-333-0956
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 320700000X
-----------------------------------------------------
Taxonomy Name | Physical Disabilities Residential Treatment Facility
-----------------------------------------------------
License Number | 45-2863789
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 45-2863789
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------