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MOUNTAIN FAMILY HEALTH CARE CENTER A MEDICAL CORPORATION NPI 1053560029


NPI Information

NPI: 1053560029
Provider Name: MOUNTAIN FAMILY HEALTH CARE CENTER, A MEDICAL CORPORATION

Doing Business As: MOUNTAIN FAMILY HEALTH CARE CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D1086657

Address:
5187 N 1ST ST STE 105
FRESNO, CA
ZIP 93710
Phone: (559) 226-6796
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MOUNTAIN FAMILY HEALTH CARE CENTER, A MEDICAL CORPORATION is a family medicine in Fresno, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MOUNTAIN FAMILY HEALTH CARE CENTER, A MEDICAL CORPORATION NPI is 1053560029. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Mountain Family Health Care Center.

The provider's business location address is:

5187 N 1ST ST STE 105
FRESNO, CA
ZIP 93710-896
Phone: (559) 226-6796
Fax: (559) 682-3061

The provider's authorized official is Neng Lee .
The authorized official title is President and has the following contact phone number (559) 226-6796.

The CLIA number assigned to this NPI record is 05D1086657 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/15/2008 and was last updated on 6/2/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine14893CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C51340MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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