Provider Demographics
NPI:1588794218
Name:FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Entity type:Organization
Organization Name:FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CALDERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-724-4102
Mailing Address - Street 1:2823 FRESNO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1324
Mailing Address - Country:US
Mailing Address - Phone:559-459-5088
Mailing Address - Fax:559-459-6914
Practice Address - Street 1:290 N WAYTE LN STE 2400
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2124
Practice Address - Country:US
Practice Address - Phone:559-459-5088
Practice Address - Fax:559-459-6914
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRESNO COMMUNITY HOSPITAL AND MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-06
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG90077-01OtherMEDICAL