ILDEFONSO CRUZ MD MEDICAL CORPORATION
NPI 1083916316
Family Medicine in Fresno, CA

Q: What is Ildefonso Cruz MD Medical Corporation's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since November 18, 2010CLIA 05D0589791 · Microscopy

1646 E HERNDON AVE STE 102, FRESNO, CA 93720(559) 449-7300(559) 449-7311 Get Directions Write a Review

NPPES record last updated: February 23, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Ildefonso Cruz Md Medical Corporation NPPES

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

ILDEFONSO CRUZ MD MEDICAL CORPORATION (NPI 1083916316) is a healthcare organization registered as a family medicine in Fresno, California and active in the NPI registry since November 2010. The organization holds a CLIA Microscopy certificate valid through August 31, 2026 and lists Ildefonso Cruz, President, as its authorized official.

NPPES Registry Identity

NPI1083916316

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameILDEFONSO CRUZ MD MEDICAL CORPORATION

Location Address1646 E HERNDON AVE STE 102Fresno, CA 93720-3380

Mailing Address1646 E Herndon Ave Ste 102Fresno, CA 93720-3380 · (559) 449-7300 · Fax (559) 449-7311

Phone(559) 449-7300

Fax(559) 449-7311

Organization SubpartNo

Authorized OfficialIldefonso CruzPresident · (559) 449-7300

Enumeration DateNovember 18, 2010

Last NPPES UpdateFebruary 23, 2024

NPPES CertifiedFebruary 23, 2024

✔ NPI 1083916316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · G28469

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1646 E HERNDON AVE STE 102, Fresno, CA 93720

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Other Identifiers 2

Other05D0589791Clia

Medicaid00G284690CA

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 for Provider-Performed Microscopy Procedures (PPMP) 05D0589791

Ildefonso Cruz MD · Fresno, CA

Active · expires Aug 31, 2026

CLIA Number05D0589791

Laboratory TypePhysician Office

Certificate Effective DateSeptember 1, 2024

Certificate Expiration DateAugust 31, 2026

Laboratory DirectorIldefonso Cruz

Laboratory Phone(559) 449-7300

Laboratory LocationIldefonso Cruz MD1646 E Herndon #102, Fresno, CA 93720

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES

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

ILDEFONSO CRUZ M D A PROFESSIONAL CORP

Family Medicine

1646 E HERNDON AVE STE 102
FRESNO, CA 93720

Fresno County (559) 449-7300

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 Ildefonso Cruz MD Medical Corporation's NPI number?

The NPI number for Ildefonso Cruz MD Medical Corporation is 1083916316. It was assigned to this organization in the NPPES registry on November 18, 2010.

Where is Ildefonso Cruz MD Medical Corporation located?

Ildefonso Cruz MD Medical Corporation is located at 1646 E Herndon Ave Ste 102, Fresno, CA 93720. The listed phone number is (559) 449-7300.

What is Ildefonso Cruz MD Medical Corporation's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Ildefonso Cruz MD Medical Corporation hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 05D0589791) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ildefonso Cruz MD Medical Corporation was last updated on February 23, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.