Organization
ANTONIO VILLALVAZO M.D. INC
Active
Other names
Family Care Clinic of Fresno
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO VILLALVAZO M.D. (OWNER)
(559) 227-1663
Entity
Organization
Contact information
Practice address
6191 N FRESNO ST, SUITE 101, FRESNO, CA 93710-8612
(559) 227-1663
(559) 227-9083
Mailing address
6191 N FRESNO ST, SUITE 101, FRESNO, CA 93710-8612
(559) 227-1663
(559) 227-9083
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C52080
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5430437
—
CA
Enumeration date
03/06/2007
Last updated
09/13/2011
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