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EL CAPITAN WOUND & DIABETIC CENTER INC
NPI 1063774008
Internal Medicine in Fresno, CA

Active since June 14, 2012CLIA 05D2133529 · Waiver
4747 N 1ST ST, 132, FRESNO, CA 93726(559) 493-5484(559) 493-5751 Get Directions Write a Review

NPPES record last updated: July 10, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About El Capitan Wound & Diabetic Center Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EL CAPITAN WOUND & DIABETIC CENTER INC (NPI 1063774008) is a healthcare organization registered as an internal medicine in Fresno, California and active in the NPI registry since June 2012. The organization holds a CLIA Waiver certificate valid through July 13, 2027 and lists Earl D Fernando, President/ceo, as its authorized official.

NPPES Registry Identity

NPI1063774008
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameEL CAPITAN WOUND & DIABETIC CENTER INC
Location Address4747 N 1ST ST, 132Fresno, CA 93726-0563
Mailing Address4747 N 1st St, 132Fresno, CA 93726-0563 · (559) 493-5484 · Fax (559) 493-5751
Phone(559) 493-5484
Fax(559) 493-5751
Organization SubpartNo
Authorized OfficialEarl D FernandoPresident/ceo · (209) 384-1400
Enumeration DateJune 14, 2012
Last NPPES UpdateJuly 10, 2014
✔ NPI 1063774008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CA · G64927
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
4747 N 1ST ST, Fresno, CA 93726
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Other Identifiers 1

Medicare OSCAR/certificationG64927CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2133529

El Capitan Wound & Diabetes · Fresno, CA
Active · expires Jul 13, 2027
CLIA Number05D2133529
Laboratory TypePhysician Office
Certificate Effective DateJuly 14, 2025
Certificate Expiration DateJuly 13, 2027
Laboratory DirectorEarl Fernando, MD
Laboratory Phone(559) 493-5484
Laboratory LocationEl Capitan Wound & Diabetes4747 N. First St. Suite 134, Fresno, CA 93726
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. EARL DON FERNANDO M.D.
Family Medicine
4747 N 1ST ST, STE134
FRESNO, CA 93726
Fresno County (559) 493-5484
DR. GENE B TOWERY D.D.S.
Dentist
4747 N 1ST ST
FRESNO, CA 93726
Fresno County (559) 226-4012
DR. EUGENE D POOLE II D.C.
Chiropractor
4747 N 1ST ST, SUITE 132
FRESNO, CA 93726
Fresno County (559) 226-9036
LISA MOUA YANG LAC, DAOM
Acupuncturist
4747 N 1ST ST, SUITE 119
FRESNO, CA 93726
Fresno County (510) 709-6607
MARTHA LAURA CRUZ MA, LMFT
Counselor (Mental Health)
4747 N 1ST ST, SUITE 119
FRESNO, CA 93726
Fresno County (559) 226-5397
DR. GENE POOLE, CHIRROPRACTOR
Chiropractor
4747 N 1ST ST, SUITE 132
FRESNO, CA 93726
Fresno County (559) 226-9036
MARTHA L. CRUZ LMFT
Community/Behavioral Health
4747 N 1ST ST, SUITE 119
FRESNO, CA 93726
Fresno County (559) 226-5397
MRS. MEREDITH FOWLER LMFT
Counselor (Mental Health)
4747 N 1ST ST, SUITE 119
FRESNO, CA 93726
Fresno County (559) 226-4570

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is El Capitan Wound & Diabetic Center Inc's NPI number?

The NPI number for El Capitan Wound & Diabetic Center Inc is 1063774008. It was assigned to this organization in the NPPES registry on June 14, 2012.

Where is El Capitan Wound & Diabetic Center Inc located?

El Capitan Wound & Diabetic Center Inc is located at 4747 N 1st St 132, Fresno, CA 93726. The listed phone number is (559) 493-5484.

What is El Capitan Wound & Diabetic Center Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does El Capitan Wound & Diabetic Center Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2133529) is associated with this NPI, valid through July 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for El Capitan Wound & Diabetic Center Inc was last updated on July 10, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.