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General NPI Number Information
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NPI Number | 1336322437
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Entity Type | Organization
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Legal Business Name | FRESNO PEDIATRICS, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 06/27/2013
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Provider Practice Location Address
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Address Line | 2900 FRESNO ST SUITE 102
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City | FRESNO
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State | CA
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Zip | 93721-1439
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Country | US
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Telephone | 559-229-2900
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Fax | 559-268-2929
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Provider Business Mailing Address
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Address Line | 2900 FRESNO ST SUITE 102
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City | FRESNO
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State | CA
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Zip | 93721-1439
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Country | US
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Telephone | 559-229-2900
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Fax | 559-268-2929
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. FRANK EPHRAIM LOPEZ
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Credential | MD
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Telephone | 559-229-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0201X
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Taxonomy Name | Pediatric Allergy/Immunology Physician
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License Number | G76384
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License Number State | CA
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