Marietta Formoso Light in Clovis - Obstetrics & Gynecology
Marietta Formoso Light - NPI 1750368650
Marietta Formoso Light is a Obstetrics & Gynecology in Clovis, California. Marietta Formoso Light practices all healthcare services and medical treatments related to Obstetrics & Gynecology. The NPI Number for Marietta Formoso Light is 1750368650. The last update date is 2020-10-08.
Marietta Formoso Light's current location address is 782 Medical Center Dr E Ste 212, Clovis, California. You can contact this provider via phone number 5594513676 and fax number 5594513680. The mailing address for Marietta Formoso Light is 782 Medical Center Dr E Ste 212, Clovis, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Marietta Formoso Light |
|---|---|
| Address | 782 Medical Center Dr E Ste 212, Clovis, California |
| Phone Number | 5594513676 |
| Fax Number | 5594513680 |
| Sole Proprietor | N |
| Credentials | NP-C |
NPI Number Detail
| NPI Number | 1750368650 |
|---|---|
| Provider Enumeration Date | 2005-12-30 |
| Last Updated Date | 2020-10-08 |
Provider Mailing Address Detail
| Address | 782 Medical Center Dr E Ste 212 |
|---|---|
| City | Clovis |
| State | California (CA) |
| Post Code | 936116889 |
| Phone Number | 5594513676 |
| Fax Number | 5594513680 |
Provider's Primary Taxonomy Detail
| Speciality | Obstetrics & Gynecology |
|---|---|
| Taxonomy | 363Lx0001X |
| Licence No | 6030 |
|
Definition: An advanced practice registered nurse expert in healthcare services related to the female reproductive system across the lifespan. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 302503 | CA | REGISTERED NURSE LIC | |
| 6030 | CA | NURSE PRACTITIONER FURN |
Post Comment/ Review Below
What is the unique identifier code issued to Marietta Formoso Light by the Centers for Medicare & Medicaid Services?
The Marietta Formoso Light has been assigned the NPI (National Provider Identifier) 1750368650. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Marietta Formoso Light is located?
The Marietta Formoso Light is situated at the following address: 782 Medical Center Dr E Ste 212, Clovis, CA, 936116889.
What is Marietta Formoso Light's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Marietta Formoso Light is Obstetrics & Gynecology, and the taxonomy code that classifies this field of practice is 363Lx0001X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1750368650 to Marietta Formoso Light?
The Centers for Medicare & Medicaid Services originally issued the 1750368650 to Marietta Formoso Light on 2005-12-30.
As of what date were the Marietta Formoso Light's details last updated?
The information pertaining to the Marietta Formoso Light, including its address, specialty, and other details, was most recently updated on 2020-10-08.
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