MEDICARE: KMY CLINIC

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	224P00000X	Prosthetist
2	261Q00000X	Clinic/Center
3	222Z00000X	Orthotist
4	335E00000X	Prosthetic/Orthotic Supplier	C50916	MD

General Provider Information

NPI Number	:	1831582220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KMY CLINIC

Provider Business Mailing Address
First Line	:	6079 N FRESNO ST STE 103
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5276
Country	:	US
Telephone Number	:	559-277-3909
Fax Number	:	559-277-3090

Provider Business Practice Location Address
First Line	:	6079 N FRESNO ST STE 103
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-5276
Country	:	US
Telephone Number	:	559-277-3909
Fax Number	:	559-277-3090

Authorized Official
Title or Position	:	CEO
Name	:	MUHAMMAD SALMAN UL-HAQ
Credential	:
Telephone Number	:	559-277-3909

Provider Enumeration Date	:	03/10/2015
Last Update Date	:	04/28/2026

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Directions to “KMY CLINIC ” Practice Location

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