NPIMap

Organization Active NPI

Gettysburg Medical Clinic, Inc.

  • Multi-Specialty Clinic/Center
  • Fresno, CA
National Provider Identifier
1063519858
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
GETTYSBURG MEDICAL CLINIC, INC.
Practice address
3128 E Gettysburg Ave
Fresno, CA 93726-0400
Phone
(559) 244-6360
Fax
(559) 229-5940
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Grace Wee Lim, M.D.NPI 1437256211
Title
President
Phone
(559) 244-6360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

3128 E Gettysburg Ave
Fresno, CA 93726-0400

Mailing address

3128 E Gettysburg Ave
Fresno, CA 93726-0400
Phone (559) 244-6360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121128000353 CA Part B Supplier - Clinic/Group Practice 5991957805 Receives reassigned benefits from 5 practitioners
4 other NPIs on this enrollment
Practice locations: Modesto, CA; Merced, CA; Fresno, CA; Atwater, CA

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3128 E Gettysburg Ave
Fresno, CA 93726
Phone (559) 225-3333

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063519858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3128 E GETTYSBURG AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260400",
            "telephone_number": "559-244-6360",
            "fax_number": "559-229-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3128 E GETTYSBURG AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260400",
            "telephone_number": "559-244-6360",
            "fax_number": "559-229-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GETTYSBURG MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "WEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "559-244-6360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.