Provider Demographics
NPI:1225251127
Name:BELMONT MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:BELMONT MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HONG
Authorized Official - Middle Name:V
Authorized Official - Last Name:KHOEUR
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:559-456-3955
Mailing Address - Street 1:4881 E BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-2324
Mailing Address - Country:US
Mailing Address - Phone:559-456-3955
Mailing Address - Fax:559-456-9931
Practice Address - Street 1:4881 E BELMONT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-2324
Practice Address - Country:US
Practice Address - Phone:559-456-3955
Practice Address - Fax:559-456-9931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty