OrganizationActive
Blue Line Medical Corp
NPI 1750015616 · Vascular Surgery Physician · Clovis, CA
Provider details
- NPI number
- 1750015616
- Entity type
- Organization
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Leo Fong, Owner/President(559) 370-8694
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3120 Willow Ave Ste 101
Clovis, CA 93612-4714
Phone: (559) 370-8694
Fax: (626) 377-4221
Approximate (ZIP-level) locationGet directions
Mailing address
1099 E. Champlain Drive
Fresno, CA 93720
Registry dates
- Enumerated
- 2022-07-14
- Last updated
- 2022-07-14
- Certified
- 2022-07-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.