Organization
EYE MEDICAL CLINIC OF FRESNO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE A. BERTOLUCCI M.D. (PRESIDENT)
(559) 449-5097
Entity
Organization
Contact information
Practice address
1360 E HERNDON AVE, SUITE 301, FRESNO, CA 93720-3326
(559) 486-5000
(559) 439-7854
Mailing address
1360 E HERNDON AVE, SUITE 301, FRESNO, CA 93720-3326
(559) 486-5000
(559) 439-7854
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD005250
—
CA
05
—
ZZZ17909Z
—
CA
Enumeration date
08/02/2006
Last updated
11/24/2009
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