Organization Name: | ETERNITY HEALTH CARE INC |
NPI Number: | 1912221748 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GILBERT D CALLIS (CEO) |
Mailing Address: | 3742 N 1st St Fresno |
State: | CA US |
Postal Code: | 937265601 |
Phone Number: | 5592292459 |
Fax Number: | 5592292936 |
NPI Enumeration Date: | 03/23/2010 |
NPI Last Update Date: | 03/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | C24147 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |