Individual
BOAZ OVADIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7060 N RECREATION AVE, SUITE 101, FRESNO, CA 93720-8022
(559) 325-5656
(559) 325-5568
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
105369- TEMP
MN
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
A92477
CA
2080P0203X
Pediatric Critical Care Medicine Physician
ME104618
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001125800
—
FL
01
—
BV993Z
MEDICARE PTAN
FL
Enumeration date
02/23/2007
Last updated
12/27/2016
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