| Mountain Family Health Care Center | |
|
5187 N 1st St Ste 105 Fresno CA 93710-7896 | |
| (559) 226-6796 | |
| (559) 682-3061 |
| Full Name | Mountain Family Health Care Center |
|---|---|
| Speciality | Family Medicine |
| Location | 5187 N 1st St Ste 105, Fresno, California |
| Authorized Official Name and Position | Neng Lee (PRESIDENT) |
| Authorized Official Contact | 5592266796 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Family Health Care Center 5187 N 1st St Ste 105 Fresno CA 93710-7896 Ph: (559) 226-6796 | Mountain Family Health Care Center 5187 N 1st St Ste 105 Fresno CA 93710-7896 Ph: (559) 226-6796 |
| NPI Number | 1053560029 |
|---|---|
| Provider Enumeration Date | 09/15/2008 |
| Last Update Date | 06/02/2023 |
| Medicare PECOS PAC ID | 8123158904 |
|---|---|
| Medicare Enrollment ID | O20100607000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053560029 | NPI | - | NPPES |
| C51340 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 14893 (California) | Primary |
| Provider Name | Pushpa Gursahani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831154673 PECOS PAC ID: 8527070812 Enrollment ID: I20060705000311 |
| Provider Name | Neng Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972511970 PECOS PAC ID: 0143319954 Enrollment ID: I20071201000198 |
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