Healthcare Provider Details

I. General information

NPI: 1992906705
Provider Name (Legal Business Name): VALLEY FAMILY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 C ST
LEMOORE CA
93245-2930
US

IV. Provider business mailing address

PO BOX 543
RIVERDALE CA
93656-0543
US

V. Phone/Fax

Practice location:
  • Phone: 559-924-7200
  • Fax: 559-924-3537
Mailing address:
  • Phone: 559-867-4416
  • Fax: 559-867-3010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHARLES SMITH
Title or Position: C.O.O.
Credential:
Phone: 559-867-4416