MEDICARE: DR. PATRICK LOUIS-JACQUES 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
1	207R00000X	Internal Medicine Physician	A77500	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992707442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK LOUIS-JACQUES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 28901
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93729-8901
Country	:	US
Telephone Number	:	559-228-4298
Fax Number	:

Provider Business Practice Location Address
First Line	:	1180 E SHAW AVE
Second Line	:	SUITE 125
City	:	FRESNO
State	:	CA
Zip	:	93710-7812
Country	:	US
Telephone Number	:	559-228-4222
Fax Number	:

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	01/31/2008

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