Provider Demographics
NPI:1477523207
Name:CHERRY & HOSHIKO A GENERAL PARTNERSHIP
Entity Type:Organization
Organization Name:CHERRY & HOSHIKO A GENERAL PARTNERSHIP
Other - Org Name:FUNCTION & ACTION PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:559-674-6202
Mailing Address - Street 1:255 W BULLARD AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0861
Mailing Address - Country:US
Mailing Address - Phone:559-299-0344
Mailing Address - Fax:559-674-6149
Practice Address - Street 1:1803 SUNSET AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-2904
Practice Address - Country:US
Practice Address - Phone:559-674-6202
Practice Address - Fax:559-674-6149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ54654ZOtherBLUE SHIELD GROUP ID #
CAZZZ54654ZOtherBLUE SHIELD GROUP ID #