Provider Demographics
NPI:1205837192
Name:GROOMS, HAROLD FELIX (MD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:FELIX
Last Name:GROOMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3812 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4301
Mailing Address - Country:US
Mailing Address - Phone:559-495-3120
Mailing Address - Fax:559-495-3134
Practice Address - Street 1:1187 E HERNDON AVE
Practice Address - Street 2:#106
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3166
Practice Address - Country:US
Practice Address - Phone:559-224-0900
Practice Address - Fax:559-224-9009
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG36121207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG36121OtherCAL STATE LIC NUMBER
CAG36121OtherCAL STATE LIC NUMBER