Provider Demographics
NPI:1982479630
Name:KAILO FAMILY CLINICS
Entity Type:Organization
Organization Name:KAILO FAMILY CLINICS
Other - Org Name:KAILO FAMILY CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HIPOLITO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARIANO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:559-721-4110
Mailing Address - Street 1:135 W SHAW AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-2825
Mailing Address - Country:US
Mailing Address - Phone:559-721-4110
Mailing Address - Fax:559-721-4110
Practice Address - Street 1:135 W SHAW AVE STE 100
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-2825
Practice Address - Country:US
Practice Address - Phone:559-721-4110
Practice Address - Fax:559-721-4110
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARIA HEALTH, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-21
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty