Organization
FOGG REMINGTON EYECARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAULA PENDLEY (CREDENTIALING)
(559) 449-5011
Entity
Organization
Contact information
Practice address
2401 W CLEVELAND AVE, MADERA, CA 93637-3608
(559) 661-7545
(559) 661-7314
Mailing address
1360 E HERNDON AVE STE 401, FRESNO, CA 93720-3326
(559) 661-7545
(559) 661-7314
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1304310001
CIGNA MEDICARE DMERC
CA
05
—
GR0078923
—
CA
Enumeration date
04/08/2006
Last updated
04/05/2022
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