KINGS WINERY MEDICLA CLINIC
NPI 1154656254
Exclusive Provider Organization in Fresno, CA
NPI Status: Active since October 07, 2009
Contact Information
4929 E KINGS CANYON RD
FRESNO, CA
ZIP 93727
Phone: (559) 255-6476
Fax: (559) 255-7906
- Organization
- Exclusive Provider Organization
- CLIA Number: 05D0715734
- CLIA Cert. Type: Federally Qualified Health Center
- CLIA Exp. Date: 08-31-2026
About KINGS WINERY MEDICLA CLINIC
This page provides the complete NPI Profile along with additional information for Kings Winery Medicla Clinic, a provider established in Fresno, California operating as a Exclusive Provider Organization. The healthcare provider is registered in the NPI registry with number 1154656254 assigned on October 2009. The practitioner's primary taxonomy code is 302F00000X with license number 040000336 (CA). The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as Kings Winery Medicla Clinic. The authorized official of this NPI record is Mr. Bla Mouanoutoua (Ceo)
- NPI
- 1154656254
- Provider Legal Name
- GREATER FRESNO HEALTH ORGNIZATION, INC.
- Other Organization Name
- KINGS WINERY MEDICLA CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 4929 E KINGS CANYON RD FRESNO, CA 93727
- Location Phone
- (559) 255-6476
- Location Fax
- (559) 255-7906
- Mailing Address
- 4929 E KINGS CANYON RD FRESNO, CA 93727
- Mailing Phone
- (559) 255-6476
- Mailing Fax
- (559) 255-7906
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-07-2009
- Last Update Date
- 04-29-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Exclusive Provider Organization
- Taxonomy Code
- 302F00000X
- Type
- Managed Care Organizations
- License No.
- 040000336
- License State
- CA
- Taxonomy Description
- (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| EAP70517F | MEDICAID (05) | CA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 05D0715734
- Facility Type
- Federally Qualified Health Center
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- APAI POLYUDHAPOON
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Kings Winery Medicla Clinic in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1154656254, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 46 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
FRESNO, CA 93727
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1154656254, enumerated as an "organization" on October 07, 2009.
The provider is located at 4929 E KINGS CANYON RD FRESNO, CA 93727 and the phone number is (559) 255-6476.
Exclusive Provider Organization with taxonomy code 302F00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
