Healthcare Provider Details

I. General information

NPI: 1790753606
Provider Name (Legal Business Name): CHERIE F. GINWALLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 VALLEY CHILDRENS PL
MADERA CA
93638-8761
US

IV. Provider business mailing address

9300 VALLEY CHILDRENS PL
MADERA CA
93638-8761
US

V. Phone/Fax

Practice location:
  • Phone: 559-353-6425
  • Fax: 559-353-6441
Mailing address:
  • Phone: 559-353-6425
  • Fax: 559-353-6441

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA66012
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: