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General NPI Number Information
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NPI Number | 1407615370
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Entity Type | Organization
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Legal Business Name | FRESNO WOUND CARE IN HOME SERVICE INC
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1954 N GATEWAY BLVD STE 102
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City | FRESNO
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State | CA
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Zip | 93727-1644
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Country | US
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Telephone | 559-475-0274
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Fax |
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Provider Business Mailing Address
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Address Line | 1954 N GATEWAY BLVD STE 102
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City | FRESNO
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State | CA
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Zip | 93727-1644
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Country | US
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Telephone | 559-475-0274
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. ISLAMBEK TARPANBAEV
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Credential |
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Telephone | 559-475-0274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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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 | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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