MEDICARE: GLENN A FUJIHARA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G40546	CA

General Provider Information

NPI Number	:	1376669218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLENN A FUJIHARA MD

Provider Business Mailing Address
First Line	:	5080 SPECTRUM DR
Second Line	:	SUITE 1200 WEST
City	:	ADDISON
State	:	TX
Zip	:	75001-4648
Country	:	US
Telephone Number	:	972-364-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	7265 N 1ST ST
Second Line	:	SUITE 105 & 103
City	:	FRESNO
State	:	CA
Zip	:	93720-2956
Country	:	US
Telephone Number	:	615-778-4066
Fax Number	:	615-778-9114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	10/18/2009

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