Organization
SAINT AGNES PATHOLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WEI FANG M.D. (AUTHORIZED OFFICIAL)
(559) 430-3130
Entity
Organization
Contact information
Practice address
1303 E. HERNDON AVENUE, FRESNO, CA 93720-3309
(559) 450-3130
(559) 450-2035
Mailing address
P.O. BOX 3246, PINEDALE, CA 93350-3246
(559) 450-3130
(559) 450-2035
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0041880
—
CA
Enumeration date
07/18/2006
Last updated
03/25/2016
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