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General NPI Number Information
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NPI Number | 1528179603
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Entity Type | Organization
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Legal Business Name | ADVANCED CARE MANAGEMENT, INC.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 2838 MARIPOSA ST
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City | FRESNO
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State | CA
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Zip | 93721-1308
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Country | US
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Telephone | 559-999-8951
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Fax | 888-630-8881
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Provider Business Mailing Address
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Address Line | 2838 MARIPOSA ST
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City | FRESNO
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State | CA
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Zip | 93721-1308
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Country | US
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Telephone | 559-999-8951
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Fax | 888-630-8881
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OPERATIONS
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Name | MR. SHELBY V JOBE
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Credential |
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Telephone | 831-212-2123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 040000552
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License Number State | CA
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