Provider Demographics
NPI:1063519858
Name:GETTYSBURG MEDICAL CLINIC, INC.
Entity type:Organization
Organization Name:GETTYSBURG MEDICAL CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:WEE
Authorized Official - Last Name:LIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-244-6360
Mailing Address - Street 1:3128 E GETTYSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-0400
Mailing Address - Country:US
Mailing Address - Phone:559-244-6360
Mailing Address - Fax:559-229-5940
Practice Address - Street 1:3128 E GETTYSBURG AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0400
Practice Address - Country:US
Practice Address - Phone:559-244-6360
Practice Address - Fax:559-229-5940
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty