Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC19759 | CA |
NPI | 1205075215 |
---|---|
Provider Name | William Edison Di Fiore JR. |
First Address | Fresno, CA 93726-1065 |
Second Address | Fresno, CA 93710-5004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2009 |
Last Update Date | 02/03/2009 |