ILDEFONSO CRUZ M D A PROFESSIONAL CORP NPI 1821399635

NPI Information

  • NPI: 1821399635
  • Provider Name: ILDEFONSO CRUZ M D A PROFESSIONAL CORP
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 1646 E HERNDON AVE STE 102
    FRESNO, CA
    ZIP 93720
  • Phone: (559) 449-7300

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NPI Details

ILDEFONSO CRUZ M D A PROFESSIONAL CORP is a family medicine in Fresno, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ILDEFONSO CRUZ M D A PROFESSIONAL CORP NPI is 1821399635. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1646 E HERNDON AVE STE 102
FRESNO, CA
ZIP 93720-380
Phone: (559) 449-7300
Fax: (559) 449-7311

The provider's authorized official is Ildefonso Cruz .
The authorized official title is President and has the following contact phone number (559) 449-7300.

The enumeration date for this NPI number is 11/10/2010 and was last updated on 2/23/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineG28469CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
105D0589791OTHERCLIA
200G284690MEDICAIDCALIFORNIA
3G28469OTHERCALIFORNIAMEDICAL LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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