Basic Information
Provider Information
NPI: 1871658641
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARAMBULA
FirstName: JOAQUIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1052 E HOGAN AVE
Address2:  
City: FRESNO
State: CA
PostalCode: 937205933
CountryCode: US
TelephoneNumber: 5593126655
FaxNumber: 5598916238
Practice Location
Address1: 1141 ROSE AVE
Address2:  
City: SELMA
State: CA
PostalCode: 936623241
CountryCode: US
TelephoneNumber: 5598916244
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/22/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XA89417CAY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


Home