Provider Demographics
NPI:1932690963
Name:FRESNO HEALTHCARE CENTER, INC.
Entity Type:Organization
Organization Name:FRESNO HEALTHCARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NOUZONG
Authorized Official - Middle Name:LYNAOLU
Authorized Official - Last Name:VANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-508-8689
Mailing Address - Street 1:3233 N CHESTNUT AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-6441
Mailing Address - Country:US
Mailing Address - Phone:559-456-1167
Mailing Address - Fax:559-456-1183
Practice Address - Street 1:3233 N CHESTNUT AVE STE 102
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-6441
Practice Address - Country:US
Practice Address - Phone:559-456-1167
Practice Address - Fax:559-456-1183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty