Active NPI
Premier Cancer Care and Infusion Center
- Non-Pharmacy Dispensing Site
- Fresno, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-Pharmacy Dispensing Site
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dina Ibrahim, MD
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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).
-
- Hematology & Oncology Physician
- Fresno, CA
- NPI 1568190064
9133591084
National Provider Directory
National Provider DirectoryLocations
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.
-
- Hematology & Oncology Physician
- Fresno, CA
- NPI 1780625376
-
- Internal Medicine Physician
- Fresno, CA
- NPI 1417906835
-
- Internal Medicine Physician
- Fresno, CA
- NPI 1659707826
-
- Primary Care Nurse Practitioner
- Fresno, CA
- NPI 1144732017
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.