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General NPI Number Information
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NPI Number | 1528798709
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Entity Type | Organization
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Legal Business Name | TRUMEDICAL CARE A PHYSICIAN ASSISTANT HEALTHCARE PARTNER CORPO
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Dates
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Enumeration Date | 06/12/2022
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Last Update Date | 01/18/2023
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Provider Practice Location Address
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Address Line | 255 W HERNDON AVE
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City | CLOVIS
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State | CA
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Zip | 93612-0381
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Country | US
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Telephone | 559-477-9889
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Fax |
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Provider Business Mailing Address
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Address Line | 255 W HERNDON AVE
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City | CLOVIS
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State | CA
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Zip | 93612-0381
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Country | US
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Telephone | 559-550-6226
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID PENA
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Credential | PA
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Telephone | 559-550-6226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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