Organization
CENTRAL CALIFORNIA CHEST SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GLORIA SUPERNAW (BILLING AND CONTRACTING MANAGER)
(559) 935-5491
Entity
Organization
Contact information
Practice address
729 N MEDICAL CENTER DR W STE 223, CLOVIS, CA 93611-6885
(559) 449-9990
(559) 449-9991
Mailing address
729 N MEDICAL CENTER DR W STE 223, CLOVIS, CA 93611-6885
(559) 449-9990
(559) 449-9991
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A99566
CA
Other
Enumeration date
11/01/2016
Last updated
02/04/2020
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