Individual
ROY CANETE OUANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2615 E CLINTON AVE, FRESNO, CA 93703-2223
(559) 225-6100
(559) 228-6909
Mailing address
2615 E CLINTON AVE, SUITE 206, FRESNO, CA 93703-2223
(559) 225-6100
(559) 228-6909
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA14002
CA
363AM0700X
Medical Physician Assistant
PA14002
CA
363AS0400X
Surgical Physician Assistant
Primary
14002
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
970012169
RAILROAD MEDICARE
—
05
—
PA14002
—
CA
Enumeration date
05/18/2006
Last updated
12/30/2015
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