Organization
CENTRAL VALLEY PEDIATRICS
Active
Other names
Central Valley Pediatrics, Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND CANUTO MIRANDA MD (PRESIDENT)
(559) 431-6600
Entity
Organization
Contact information
Practice address
7011 N HOWARD ST, SUITE 106, FRESNO, CA 93720-2955
(559) 431-6600
Mailing address
7011 N HOWARD ST, SUITE 106, FRESNO, CA 93720-2955
(559) 431-6600
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
G66119
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G661190
—
CA
Enumeration date
01/27/2012
Last updated
01/27/2012
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