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Organization
REGENTS OF UNIVERSITY OF CALIFORNIA
Active
Organization
REGENTS OF UNIVERSITY OF CALIFORNIA
Active
Other names
UCSF-Fresno Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PETERSON MD (ASSOCIATE DEAN)
(559) 499-6400
Entity
Organization
Contact information
Practice address
155 N FRESNO ST, FRESNO, CA 93701-2302
(559) 499-6400
(559) 499-6411
Mailing address
155 N FRESNO ST, FRESNO, CA 93701-2302
(559) 499-6400
(559) 499-6411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0091020
MEDI-CAL
CA
Enumeration date
02/02/2007
Last updated
08/25/2021
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