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General NPI Number Information
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NPI Number | 1396721197
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Entity Type | Organization
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Legal Business Name | OMNI WOMENS HEALTH MEDICAL GROUP INC
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 3812 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 | 559-495-3120
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Fax | 559-495-3134
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Provider Business Mailing Address
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Address Line | 3812 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 | 559-495-3120
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Fax | 559-495-3134
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FENGLALY CHERTA LEE
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Credential | M.D.
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Telephone | 559-495-3120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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