1. Home
  2. Directory
  3. California
  4. Fresno
  5. Family Medicine
  6. NPI Profile

CALIFORNIA STATE UNIVERSITY FRESNO ATHLETIC CORPORATION
NPI 1205186061
Family Medicine - Sports Medicine in Fresno, CA

Active since September 19, 2012
1620 E BULLDOG LN, FRESNO, CA 93740(559) 278-4170(559) 278-8355 Get Directions Write a Review

NPPES record last updated: September 19, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About California State University Fresno Athletic Corporation NPPES

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

CALIFORNIA STATE UNIVERSITY FRESNO ATHLETIC CORPORATION (NPI 1205186061) is a healthcare organization registered as a sports medicine in Fresno, California and active in the NPI registry since September 2012. The organization lists Betsy Mosher, Director Of Athletics, as its authorized official.

NPPES Registry Identity

NPI1205186061
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameCALIFORNIA STATE UNIVERSITY FRESNO ATHLETIC CORPORATION
Location Address1620 E BULLDOG LNFresno, CA 93740-0001
Mailing Address1620 E Bulldog LnFresno, CA 93740-0001 · (559) 278-4170 · Fax (559) 278-8355
Phone(559) 278-4170
Fax(559) 278-8355
Organization SubpartNo
Authorized OfficialBetsy MosherDirector Of Athletics · (559) 278-4905
Enumeration DateSeptember 19, 2012
✔ NPI 1205186061 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
1620 E BULLDOG LN, Fresno, CA 93740
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

MR. DAVID JACK ATC
Specialist/Technologist (Athletic Trainer)
1620 E BULLDOG LN
FRESNO, CA 93740
Fresno County (559) 278-4170
SEAN FITZSIMMONS
Specialist/Technologist (Athletic Trainer)
1620 E BULLDOG LN
FRESNO, CA 93740
Fresno County (559) 278-4170
SARAH TACKETT ATC
Specialist/Technologist (Athletic Trainer)
1620 E BULLDOG LN, MS OF87
FRESNO, CA 93740
Fresno County (559) 278-4170
MR. ANTHONY HILL MS, ATC, PES
Specialist/Technologist (Athletic Trainer)
1620 E BULLDOG LN
FRESNO, CA 93740
Fresno County (559) 278-2597

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 California State University Fresno Athletic Corporation's NPI number?

The NPI number for California State University Fresno Athletic Corporation is 1205186061. It was assigned to this organization in the NPPES registry on September 19, 2012.

Where is California State University Fresno Athletic Corporation located?

California State University Fresno Athletic Corporation is located at 1620 E Bulldog Ln, Fresno, CA 93740. The listed phone number is (559) 278-4170.

What is California State University Fresno Athletic Corporation's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

When was this NPI record last updated?

The NPPES record for California State University Fresno Athletic Corporation was last updated on September 19, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.