Payment Page

Claim # or Ticket #

Patient Name

Phone Number

Amount

Credit Card Surcharge

Total

To cover the cost of accepting credit cards, we will collect a 3% credit card surcharge.

Enter entire balance due. If you are making payments please contact our office at: (559) 475-9821

Card Number

Expiration Date

Security Code (CVV)

First Name

Last Name

Address 1

Address 2

City

State

Zip/Postal Code

Country

Please enter valid email address so we can contact you in case of any issues with your payment.

Email Address

lock Payment Page