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General NPI Number Information
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NPI Number | 1720556970
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Entity Type | Organization
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Legal Business Name | PACIFIC MEDICL CENTER OF HOPE
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Dates
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Enumeration Date | 11/06/2018
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 1680 E HERNDON AVE STE 102
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City | FRESNO
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State | CA
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Zip | 93720-3384
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Country | US
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Telephone | 559-439-5393
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Fax | 559-439-5828
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Provider Business Mailing Address
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Address Line | 496 OLD NEWPORT BLVD STE 107
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4263
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Country | US
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Telephone | 949-515-4673
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Fax | 949-515-4672
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SHANNON SIMS
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Credential |
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Telephone | 559-439-5393
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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 |
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License Number State |
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