Organization
FRED H. NAGATA, D.P.M., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED HISAO NAGATA D.P.M. (OWNER)
(559) 435-3039
Entity
Organization
Contact information
Practice address
1191 E HERNDON AVE STE 101, FRESNO, CA 93720-3164
(559) 435-3039
(559) 435-1105
Mailing address
1191 E HERNDON AVE STE 101, FRESNO, CA 93720-3164
(559) 435-3039
(559) 435-1105
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2516
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOOE25160
—
CA
Enumeration date
07/01/2009
Last updated
07/01/2009
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