Organization Active NPI

Premier Cancer Care and Infusion Center

  • Non-Pharmacy Dispensing Site
  • Fresno, CA
National Provider Identifier
1740051978
Registry record updated Jun 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
PREMIER CANCER CARE AND INFUSION CENTER
Practice address
6121 N Thesta St Ste 204
Fresno, CA 93710-5294
Phone
(559) 554-2100
Fax
(559) 554-2114
NPI assigned
Jan 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2025

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

Authorized official

Name
Dina Ibrahim, MDNPI 1780625376
Title
Ceo
Phone
(559) 554-2100

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
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

6121 N Thesta St Ste 204
Fresno, CA 93710-5294

Mailing address

PO Box 26897
Fresno, CA 93729-6897
Phone (877) 747-5050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240702002364 CA Part B Supplier - Pharmacy 9133591084 Practice locations: Fresno, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

7065 N Maple Ave
Ste 102
Fresno, CA 93720
Phone (559) 322-0887

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750550400000",
    "number": "1740051978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26897",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937296897",
            "telephone_number": "877-747-5050",
            "fax_number": "775-747-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 N THESTA ST STE 204",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937105294",
            "telephone_number": "559-554-2100",
            "fax_number": "559-554-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER CANCER CARE AND INFUSION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-16",
        "last_updated": "2025-06-22",
        "certification_date": "2025-06-22",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-554-2100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "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 Jun 22, 2025; 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.