Individual
HERBERT GANAH BIVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2823 FRESNO ST, FRESNO, CA 93721-1324
(559) 499-6440
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
G40063
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G400630
—
CA
Enumeration date
08/23/2006
Last updated
01/27/2021
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