Organization
HIPOLITO G. MARIANO, JR., MD, INC.
Active
Other names
Fresno Family Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HIPOLITO GALLARDO MARIANO JR. M.D. (PRESIDENT)
(559) 412-4927
Entity
Organization
Contact information
Practice address
3121 E OLIVE AVE, FRESNO, CA 93702-1030
(559) 412-4927
(559) 493-5028
Mailing address
3121 E OLIVE AVE, FRESNO, CA 93702-1030
(559) 412-4927
(559) 493-5028
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
A88903
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A889030
—
CA
Enumeration date
07/31/2009
Last updated
04/18/2016
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