Basic Information
| Provider Information | |||||||||
| NPI: | 1932177839 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIELDS | ||||||||
| FirstName: | DONALD | ||||||||
| MiddleName: | W. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9590 N KEYSTONE CT | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937200706 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 290 N WAYTE LN | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937012124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594594300 | ||||||||
| FaxNumber: | 5594594569 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2006 | ||||||||
| LastUpdateDate: | 07/03/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MTL-2017-069 | GU | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | 20A6702 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.