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Organization
PARADISE FAMILY HEALTH CENTER
Active
Organization
PARADISE FAMILY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLANCA I FRESNO MD (ADMINISTRATOR)
(619) 475-4575
Entity
Organization
Contact information
Practice address
655 EUCLID AVE, SUITE #207, NATIONAL CITY, CA 91950-2957
(619) 475-4575
Mailing address
4364 BONITA RD, PB #467, BONITA, CA 91902-1421
(619) 475-4575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0068530
—
CA
Enumeration date
12/08/2005
Last updated
05/17/2010
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