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DR. ILDEFONSO CRUZ M.D. NPI 1275689085


NPI Information

NPI: 1275689085
Provider Name: DR. ILDEFONSO CRUZ, M.D.
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 05D0589791

Address:
1646 E HERNDON AVE STE 102
FRESNO, CA
ZIP 93720
Phone: (559) 449-7300
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DR. Ildefonso Cruz, M.D. is a family medicine in Fresno, CA with 51 years of experience. 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. DR. Ildefonso Cruz, M.D. NPI is 1275689085. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1973

The provider's business location address is:

1646 E HERNDON AVE STE 102
FRESNO, CA
ZIP 93720-380
Phone: (559) 449-7300
Fax: (559) 449-7311

The NPI 1275689085 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D0589791 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • Administration of influenza virus vaccine (HCPCS:G0008)

The enumeration date for this NPI number is 1/25/2007 and was last updated on 7/8/2007.


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 MedicineG28469CALIFORNIAYes

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
1AC6458029OTHERDEA
2C04168MEDICARE UPIN
3G28469OTHERCALIFORNIALICENSE

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.