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NPI Code Detail

MEDICARE: BRIAN FARR CHINNOCK M.D.

MEDICARE: BRIAN FARR CHINNOCK M.D.
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
1207P00000XEmergency Medicine PhysicianA61117CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A61117OTHERCASTATE LICENSE

General Provider Information

NPI Number : 1861481947
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN FARR CHINNOCK M.D.
Provider Business Mailing Address
First Line : 2625 E DIVISADERO ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1431
Country : US
Telephone Number : 559-443-2682
Fax Number : 559-443-2681
Provider Business Practice Location Address
First Line : 2823 FRESNO ST
Second Line :
City : FRESNO
State : CA
Zip : 93721-1324
Country : US
Telephone Number : 559-499-6440
Fax Number : 559-499-6441
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2005
Last Update Date : 01/27/2021

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