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Organization

PALM MEDICAL GROUP, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SU ROSENTHAL (MANAGER)
(559) 222-9200
Entity
Organization

Contact information

Practice address
222 W SHAW AVE, FRESNO, CA 93704-2644
(559) 222-9200
(559) 222-9201
Mailing address
222 W SHAW AVE, FRESNO, CA 93704-2644
(559) 222-9200
(559) 222-9201

Taxonomy

Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
FNP22936
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
FNP22936
FICTIOUS NAME PERMIT
CA
Enumeration date
02/06/2007
Last updated
08/22/2020
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