Individual
GARY W VANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7300 N FRESNO ST, FRESNO, CA 93720-2941
(559) 448-4500
Mailing address
5682 W BEECHWOOD AVE, FRESNO, CA 93722-2640
(559) 271-7062
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A25116
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A251160
—
CA
Enumeration date
09/13/2006
Last updated
07/08/2007
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