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General NPI Number Information
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NPI Number | 1467792176
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD WALK IN CLINIC
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Dates
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Enumeration Date | 02/18/2013
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Last Update Date | 09/25/2013
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Provider Practice Location Address
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Address Line | 4182 N 1ST ST STE 105
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City | FRESNO
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State | CA
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Zip | 93726-4300
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Country | US
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Telephone | 559-224-3300
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Fax | 559-224-3306
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Provider Business Mailing Address
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Address Line | 4182 N 1ST ST STE 105
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City | FRESNO
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State | CA
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Zip | 93726-4300
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Country | US
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Telephone | 559-224-3300
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Fax | 559-224-3306
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CAMILLE MUNGANGA
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Credential | N.P.
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Telephone | 714-458-0207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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