Provider Demographics
NPI:1427415785
Name:KMY PRIMARY CARE, INC
Entity Type:Organization
Organization Name:KMY PRIMARY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAJEEBULLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-277-3909
Mailing Address - Street 1:7210 N MILBURN AVE
Mailing Address - Street 2:105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-8448
Mailing Address - Country:US
Mailing Address - Phone:559-277-3909
Mailing Address - Fax:559-277-3090
Practice Address - Street 1:7210 N MILBURN AVE
Practice Address - Street 2:105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-8448
Practice Address - Country:US
Practice Address - Phone:559-277-3909
Practice Address - Fax:559-277-3090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-18
Last Update Date:2016-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty