Organization
ADVANCED LAPAROSCOPIC SURGERY ASSOCIATES MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELVIN M HIGA MD (PRESIDENT)
(559) 228-5448
Entity
Organization
Contact information
Practice address
205 E RIVER PARK CIR, #460, FRESNO, CA 93720-1571
(559) 261-4500
Mailing address
PO BOX 28947, FRESNO, CA 93729-8947
(559) 228-5448
(559) 224-3920
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G53771
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0098660
—
CA
01
—
ZZZ26512Z
MEDICARE
CA
Enumeration date
04/11/2006
Last updated
02/13/2013
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