Healthcare Provider Details

I. General information

NPI: 1609279959
Provider Name (Legal Business Name): PORTERVILLE WOMEN'S MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 N KESSING ST
PORTERVILLE CA
93257-3424
US

IV. Provider business mailing address

254 N KESSING ST
PORTERVILLE CA
93257-3424
US

V. Phone/Fax

Practice location:
  • Phone: 559-781-8500
  • Fax: 559-781-8300
Mailing address:
  • Phone: 559-781-8500
  • Fax: 559-781-8300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number235681
License Number StateCA

VIII. Authorized Official

Name: MICHAEL GEILING
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 559-781-8500