California State University Fresno Athletic Corporation
California State University Fresno Athletic Corporation provides Sports Medicine (Family Medicine) Physician services in Fresno, California. Registered with an NPI since 2012.
- In the registry since
- 2012
- Specialties on file
- 2
Practice location Address checks out
1620 E Bulldog LnFresno, CA 93740-0001 Not confirmed with CMS for 14 years — call before visiting
Phone: (559) 278-4170
Fax: (559) 278-8355
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Sports Medicine (Family Medicine) Physician (primary) | Taxonomy 207QS0010X |
|---|---|
| Orthopaedic Surgery Physician | Taxonomy 207X00000X |
Record details
| NPI number | 1205186061 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Betsy Mosher — Director Of Athletics · (559) 278-4905 |
| NPI enumerated | September 19, 2012 |
| Last updated in NPPES | September 19, 2012 |
| Mailing address | 1620 E Bulldog Ln, Fresno, CA 93740-0001 |
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