Provider Demographics
NPI:1851835417
Name:FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Entity Type:Organization
Organization Name:FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Other - Org Name:FRESNO COMMUNITY IOM
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:559-324-4884
Mailing Address - Street 1:PO BOX 1232
Mailing Address - Street 2:2823 FRESNO ST
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1324
Mailing Address - Country:US
Mailing Address - Phone:559-459-2424
Mailing Address - Fax:559-459-2974
Practice Address - Street 1:2823 FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1324
Practice Address - Country:US
Practice Address - Phone:559-459-2424
Practice Address - Fax:559-459-2974
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-15
Last Update Date:2022-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0400000096282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital