Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | C38922 | CA |
NPI | 1184769879 |
---|---|
Provider Name | Dr. Denard Manuel Fobbs SR. |
First Address | Fresno, CA 93729-6990 |
Second Address | Fresno, CA 93710-6851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0056972 | DRS' CO. MALPRACTICE INS. (01) | CA |
2637617 | (05) | CA |
A89067 | (02) | CA |
AF9274541 | DEA REGISTRATION NUMBER (01) | CA |
C38922 | CALIF. LICENSE NUMBER (01) | CA |
E8471 | TEXAS LICENSE NUMBER (01) | TX |