Most Relevant Information
Provider Data
| NPI Number: | 1003231523 |
| Provider Name: | GREGORY AIFEHIENGBE IDONI |
| Entity Type: | Individual |
| Taxonomy Code: | 376G00000X |
| Specialty: | Nursing Home Administrator |
| License Number: | 107206634 |
Most Important Dates
| Enumeration Date: | 02/19/2014 |
| Last Updated: | 02/19/2014 |
Provider Practice Location
3618 W DAYTON AVE
FRESNO
CA
937224704
Practice Location Phone/Fax
| Phone: | 5592752488 |
| Fax: | 5592752488 |
Provider Mailing Location
3618 W DAYTON AVE
FRESNO
CA
937224704
Provider Mailing Phone/Fax
| Phone: | 5592752488 |
| Fax: | 5592752488 |