Provider Demographics
NPI:1609648500
Name:FEARS, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:FEARS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:CHOWCHILLA
Mailing Address - State:CA
Mailing Address - Zip Code:93610-3106
Mailing Address - Country:US
Mailing Address - Phone:559-660-3671
Mailing Address - Fax:
Practice Address - Street 1:635 S 8TH ST
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-3106
Practice Address - Country:US
Practice Address - Phone:559-660-3671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6JHV315347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle