Provider Demographics
NPI:1184769879
Name:FOBBS, DENARD MANUEL SR (MD)
Entity type:Individual
Prefix:DR
First Name:DENARD
Middle Name:MANUEL
Last Name:FOBBS
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26990
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-6990
Mailing Address - Country:US
Mailing Address - Phone:559-225-7600
Mailing Address - Fax:559-225-2472
Practice Address - Street 1:5339 N FRESNO ST STE 105E
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6851
Practice Address - Country:US
Practice Address - Phone:559-225-7600
Practice Address - Fax:559-225-2472
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC38922207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0056972OtherDRS' CO. MALPRACTICE INS.
CA2637617Medicaid
TXE8471OtherTEXAS LICENSE NUMBER
CAC38922OtherCALIF. LICENSE NUMBER
CAC38922OtherCALIF. LICENSE NUMBER
CA2637617Medicaid