MEDICARE: RAUL TELLEZ RODRIGUEZ FNP-C

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	363L00000X	Nurse Practitioner	95031897	CA

General Provider Information

NPI Number	:	1679307797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAUL TELLEZ RODRIGUEZ FNP-C

Provider Business Mailing Address
First Line	:	7121 N WHITNEY AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93720-0151
Country	:	US
Telephone Number	:	559-299-9395
Fax Number	:

Provider Business Practice Location Address
First Line	:	451 E ALMOND AVE STE 103
Second Line	:
City	:	MADERA
State	:	CA
Zip	:	93637-5562
Country	:	US
Telephone Number	:	559-673-4000
Fax Number	:	559-673-3661

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

Provider Enumeration Date	:	08/30/2024
Last Update Date	:	11/11/2024

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Directions to “ RAUL TELLEZ RODRIGUEZ FNP-C” Practice Location

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