Individual
MR. GREGORY AIFEHIENGBE IDONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3618 W DAYTON AVE, FRESNO, CA 93722-4704
(559) 275-2488
(559) 275-2488
Mailing address
3618 W DAYTON AVE, FRESNO, CA 93722-4704
(559) 275-2488
(559) 275-2488
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
107206634
CA
Other
Enumeration date
02/19/2014
Last updated
02/19/2014
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