# IMPACT MEDICAL GROUP, PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1891999108
- **Authorized official:** IFEATU EKELEM MD (MD)
- **Authorized official phone:** (559) 452-1000

## Contact information

- **Practice address:** 5261 E KINGS CANYON RD, SUITE 107, FRESNO, CA 93727-4028
- **Practice address phone:** (559) 452-1000
- **Mailing address:** 5261 E KINGS CANYON RD, SUITE 107, FRESNO, CA 93727-4028
- **Mailing address phone:** (559) 452-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/12/2007
- **Last updated:** 05/25/2016