Healthcare Provider Details

I. General information

NPI: 1013961721
Provider Name (Legal Business Name): VALLEY NUCLEAR MEDICAL GROUP INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 06/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E ALMOND AVE
MADERA CA
93637-5606
US

IV. Provider business mailing address

PO BOX 6102
NOVATO CA
94948-6102
US

V. Phone/Fax

Practice location:
  • Phone: 559-675-5555
  • Fax: 559-675-5591
Mailing address:
  • Phone: 415-884-3404
  • Fax: 415-883-1836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207UN0902X
TaxonomyNuclear Imaging & Therapy Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL PATRICK
Title or Position: PRESIDENT
Credential: MD
Phone: 559-675-5555