Organization
ART
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVAN KLETTER MD (CEO)
(415) 552-7914
Entity
Organization
Contact information
Practice address
539 N VAN NESS AVE, FRESNO, CA 93728-3419
(559) 266-9581
(559) 498-0507
Mailing address
539 N VAN NESS, FRESNO, CA 93728
(559) 266-9581
(559) 498-0507
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
10-01
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659419828
NPI NUM,BER
CA
Enumeration date
10/21/2008
Last updated
10/21/2008
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