Provider Demographics
NPI:1235650391
Name:PLASTIC SURGERY PARTNERS OF FRESNO INC
Entity Type:Organization
Organization Name:PLASTIC SURGERY PARTNERS OF FRESNO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERICH
Authorized Official - Middle Name:STEFAN
Authorized Official - Last Name:LEMKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-459-4101
Mailing Address - Street 1:215 N FRESNO ST, STE 490
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93701
Mailing Address - Country:US
Mailing Address - Phone:559-459-4101
Mailing Address - Fax:559-459-5744
Practice Address - Street 1:215 N FRESNO ST, STE 490
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701
Practice Address - Country:US
Practice Address - Phone:559-459-4101
Practice Address - Fax:559-459-5744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2020-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG24836208200000X
208200000X, 2082S0099X
CAA95116208600000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and NeckGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty