1396175204 NPI number — WOMEN'S SPECIALTY & FERTILITY CENTER, INC.

Table of content: (NPI 1396175204)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396175204 NPI number — WOMEN'S SPECIALTY & FERTILITY CENTER, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WOMEN'S SPECIALTY & FERTILITY CENTER, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1396175204
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
729 NORTH MEDICAL CENTER DRIVE WEST
Provider Second Line Business Mailing Address:
SUITE 205
Provider Business Mailing Address City Name:
CLOVIS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93611-6879
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-229-7700
Provider Business Mailing Address Fax Number:
559-297-9679

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1180 E SHAW AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93710-7812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-228-5448
Provider Business Practice Location Address Fax Number:
559-224-3920
Provider Enumeration Date:
11/14/2013

Additional Information

Authorized Official

Authorized Official Last Name:
SYNN
Authorized Official First Name:
HOWARD
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
559-229-7700

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  G57475 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com