| Prodigy Healthcare Inc. | |
|
1900 18th Ave Kingsburg CA 93631-1629 | |
| (559) 892-9452 | |
| Not Available |
| Full Name | Prodigy Healthcare Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1900 18th Ave, Kingsburg, California |
| Authorized Official Name and Position | Jagdip Dhanda (CEO) |
| Authorized Official Contact | 5598929452 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prodigy Healthcare Inc. Po Box 820 Fowler CA 93625-0820 Ph: (559) 892-9452 | Prodigy Healthcare Inc. 1900 18th Ave Kingsburg CA 93631-1629 Ph: (559) 892-9452 |
| NPI Number | 1972955227 |
|---|---|
| Provider Enumeration Date | 07/11/2016 |
| Last Update Date | 07/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972955227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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