Healthcare Provider Details

I. General information

NPI: 1932641644
Provider Name (Legal Business Name): OAK HILLS MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2016
Last Update Date: 08/26/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 MAIN ST
DELANO CA
93215-2953
US

IV. Provider business mailing address

PO BOX 748792 STE 106
LOS ANGELES CA
90074-8792
US

V. Phone/Fax

Practice location:
  • Phone: 661-324-4100
  • Fax: 661-324-4600
Mailing address:
  • Phone: 661-324-4100
  • Fax: 661-324-4600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State

VIII. Authorized Official

Name: PROF. MADELINE ANGELA MEYER
Title or Position: DIRECTOR
Credential: PHD
Phone: 321-274-8344