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General NPI Number Information
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NPI Number | 1639370588
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Entity Type | Organization
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Legal Business Name | DOUGLAS S. STANLEY, M.D., INC.
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7780 N FRESNO ST SUITE 102
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City | FRESNO
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State | CA
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Zip | 93720-2413
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Country | US
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Telephone | 559-447-9027
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Fax | 559-447-1675
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Provider Business Mailing Address
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Address Line | 7780 N FRESNO ST SUITE 102
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City | FRESNO
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State | CA
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Zip | 93720-2413
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Country | US
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Telephone | 559-447-9027
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Fax | 559-447-1675
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Authorized Official
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Title or Position | M.D.OWNER
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Name | DR. DOUGLAS S. STANLEY
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Credential | M.D.
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Telephone | 559-447-9027
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A71417
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License Number State | CA
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