Organization
UCSF FRESNO MEDICAL GROUP
Active
Parent organization
UNIVERSITY OF CALIFORNIA
Other names
UCSF Fresno Allied Medical Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF CALIFORNIA
Authorized official
DR. JOAN VORIS MEDICAL DOCTOR (ASSOICATE DEAN)
(559) 499-6427
Entity
Organization
Contact information
Practice address
3313 N HILLIARD ST, FRESNO, CA 93726-5854
(559) 227-4810
(559) 227-4167
Mailing address
PO BOX 60000, FILE 740522, SAN FRANCISCO, CA 94160-0001
(559) 227-4810
(559) 227-4167
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
20822
CA
103G00000X
Clinical Neuropsychologist
Primary
PSY19509
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1821014374
NPI
CA
05
—
2342434
—
CA
01
—
9151935
MEDI-CAL PIN
CA
01
—
CK5696
RAILROAD MEDICARE
CA
05
—
GPS001380
—
CA
05
—
GR0091021
—
CA
01
—
ZZZ5296Y
BLUE OF CA
CA
Enumeration date
01/03/2008
Last updated
05/28/2009
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