Healthcare Provider Details

I. General information

NPI: 1255579421
Provider Name (Legal Business Name): CENTRAL CALIFORNIA INPATIENT PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2009
Last Update Date: 04/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 TRANCAS ST
NAPA CA
94558-2906
US

IV. Provider business mailing address

PO BOX 79696
CITY OF INDUSTRY CA
91716-9696
US

V. Phone/Fax

Practice location:
  • Phone: 707-252-4411
  • Fax:
Mailing address:
  • Phone: 330-470-3700
  • Fax: 330-497-7940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: E P REID
Title or Position: OWNER
Credential:
Phone: 866-885-5522