Wilfred Derksen
Pediatrician
1570 E Herndon Ave
Fresno
, California 93720-3303
Wilfred Derksen
Pediatrician
1570 E Herndon Ave
Fresno
, California 93720-3303
(559) 224-3920
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- Wilfred Derksen
- Po Box 28900
- Fresno, CA
- Zip : 93729-8900
- Fax : (559) 224-3920
- Phone : (559) 228-4205
Second Address
- Wilfred Derksen
- 1570 E Herndon Ave
- Fresno, CA
- Zip : 93720-3303
- Fax : (559) 437-7153
- Phone : (559) 437-7300
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | C33691 | CA |
National Provider Identifier
| NPI | 1003801267 |
|---|---|
| Provider Name | Wilfred Derksen |
| First Address | Fresno, CA 93729-8900 |
| Second Address | Fresno, CA 93720-3303 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/09/2005 |
| Last Update Date | 30/04/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| A35349 | (02) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.