El Capitan Wound & Diabetic Center Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G64927 Issued in CA

Legal business name

EL CAPITAN WOUND & DIABETIC CENTER INC

Practice address

4747 N 1St St
132
Fresno, CA 93726-0563

Phone

(559) 493-5484

Fax

(559) 493-5751

NPI assigned

Jun 14, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Earl D Fernando, M.D.

Title

President/Ceo

Phone

(209) 384-1400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• El Capitan Wound & Diabetic Center Inc

  • Internal Medicine Physician
  • Fresno, CA
  • NPI 1326462631

  O20120724000501

  Same enrollment

Locations

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404950400000",
    "number": "1063774008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 N 1ST ST",
            "address_2": "132",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260563",
            "telephone_number": "559-493-5484",
            "fax_number": "559-493-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 N 1ST ST",
            "address_2": "132",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937260563",
            "telephone_number": "559-493-5484",
            "fax_number": "559-493-5751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CAPITAN WOUND & DIABETIC CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2014-07-10",
        "status": "A",
        "authorized_official_last_name": "FERNANDO",
        "authorized_official_first_name": "EARL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "209-384-1400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G64927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessa Marie Ekern
• Hakob Ekmekchyan, DDS
• Suzanna Ekmekchyan, DDS
• Iboro D Ekpo
• Lisa Marie El Alami
• El Capitan Wound & Diabetic Center Inc
• Aseel A El-Jabali, MBBS
• Hossam El-Zuhery
• Afarin Elahi, RPH
• Beatrice Elan

• Internal Medicine Physician in Fresno, CA
• Providers in Fresno, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2014; 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.