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ANTONIO VILLALVAZO M.D. INC NPI 1629108824


NPI Information

NPI: 1629108824
Provider Name: ANTONIO VILLALVAZO M.D. INC

Doing Business As: FAMILY CARE CLINIC OF FRESNO

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D1064280

Address:
6191 N FRESNO ST
SUITE 101
FRESNO, CA
ZIP 93710
Phone: (559) 227-1663
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ANTONIO VILLALVAZO M.D. INC 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. ANTONIO VILLALVAZO M.D. INC NPI is 1629108824. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Family Care Clinic Of Fresno.

The provider's business location address is:

6191 N FRESNO ST
SUITE 101
FRESNO, CA
ZIP 93710-612
Phone: (559) 227-1663
Fax: (559) 227-9083

The provider's authorized official is Antonio Villalvazo .
The authorized official title is Owner and has the following contact phone number (559) 227-1663.

The CLIA number assigned to this NPI record is 05D1064280 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/6/2007 and was last updated on 9/13/2011.


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 MedicineC52080CALIFORNIAYes

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
15430437MEDICAIDCALIFORNIA
2=========OTHERCALIFORNIATIN
3169393MEDICARE UPINCALIFORNIA
400C52080MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

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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