Facts
- Status
- A
- Type
- Individual
- Enumeration date
- 2006-12-22
- Last updated
- 2007-07-08
Specialties
Licenses
- License CA
- A89417
Location
- Practice location
- 1141 ROSE AVE
- City
- SELMA CA
- Postal code
- 936623241
- Phone
- 559-891-6244
Medicare
- PECOS
- No PECOS enrollment row matched 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.