Basic Information
| Provider Information | |||||||||
| NPI: | 1568135994 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY HEALTH PARTNERS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 789 MEDICAL CENTER DRIVE EAST | ||||||||
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| City: | CLOVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93611 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2823 FRESNO ST | ||||||||
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| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937211324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594596000 | ||||||||
| FaxNumber: | 5594595097 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2021 | ||||||||
| LastUpdateDate: | 07/30/2021 | ||||||||
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| AuthorizedOfficialLastName: | RAMIREZ | ||||||||
| AuthorizedOfficialFirstName: | PATRICK | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5593244952 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | COMMUNITY HEALTH PARTNERS | ||||||||
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| NPICertificationDate: | 06/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 207L00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.