| Jim Phanucharas, M.d., Inc. | |
|
7797 N 1st St # 270 Fresno CA 93720-0962 | |
| (559) 261-2566 | |
| (559) 435-4319 |
| Full Name | Jim Phanucharas, M.d., Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 7797 N 1st St # 270, Fresno, California |
| Authorized Official Name and Position | Jim Phanucharas (OWNER PHYSICIAN) |
| Authorized Official Contact | 5592612566 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jim Phanucharas, M.d., Inc. 7797 N 1st St # 270 Fresno CA 93720-0962 Ph: (559) 261-2566 | Jim Phanucharas, M.d., Inc. 7797 N 1st St # 270 Fresno CA 93720-0962 Ph: (559) 261-2566 |
| NPI Number | 1194932236 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 1658479407 |
|---|---|
| Medicare Enrollment ID | O20070601000593 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194932236 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A82493 (California) | Primary |
| Provider Name | Jim Phanucharas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578583597 PECOS PAC ID: 5698724631 Enrollment ID: I20050118000362 |
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