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General NPI Number Information
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NPI Number | 1689856171
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Entity Type | Organization
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Legal Business Name | CALIFORNIA INDUSTRIAL MEDICINE, INC.
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 2841 TULARE ST
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City | FRESNO
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State | CA
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Zip | 93721-1320
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Country | US
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Telephone | 559-435-3696
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Fax | 559-435-3698
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Provider Business Mailing Address
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Address Line | 2841 TULARE ST
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City | FRESNO
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State | CA
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Zip | 93721-1320
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Country | US
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Telephone | 559-435-3696
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Fax | 559-435-3698
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | C12065
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License Number State | CA
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