# EYE MEDICAL CLINIC OF FRESNO, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306853452
- **Authorized official:** DR. GEORGE A. BERTOLUCCI M.D. (PRESIDENT)
- **Authorized official phone:** (559) 449-5097

## Contact information

- **Practice address:** 1360 E HERNDON AVE, SUITE 301, FRESNO, CA 93720-3326
- **Practice address phone:** (559) 486-5000
- **Practice address fax:** (559) 439-7854
- **Mailing address:** 1360 E HERNDON AVE, SUITE 301, FRESNO, CA 93720-3326
- **Mailing address phone:** (559) 486-5000
- **Mailing address fax:** (559) 439-7854

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/02/2006
- **Last updated:** 11/24/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GSD005250 | — | CA |
| 05 | — | ZZZ17909Z | — | CA |