Facts
- Status
- A
- Credential
- DC
- Type
- Individual
- Enumeration date
- 2006-06-06
- Last updated
- 2014-07-31
Specialties
Licenses
- License CA
- DC15151
Location
- Practice location
- 1717 MILL ST
- City
- SELMA CA
- Postal code
- 936623712
- Phone
- 559-472-7314
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.