Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

California State University Fresno Athletic Corporation

Organization Sports Medicine (Family Medicine) Physician · NPI 1205186061

California State University Fresno Athletic Corporation is a Sports Medicine (Family Medicine) Physician in Fresno, California. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
2

Practice location Address checks out

1620 E Bulldog Ln
Fresno, CA 93740-0001
Phone: (559) 278-4170
Fax: (559) 278-8355
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X
Orthopaedic Surgery Physician Taxonomy 207X00000X

Record details

NPI number1205186061
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Betsy Mosher — Director Of Athletics · (559) 278-4905
NPI enumeratedSeptember 19, 2012
Last updated in NPPESSeptember 19, 2012
Mailing address1620 E Bulldog Ln, Fresno, CA 93740-0001

Other providers in Fresno