Healthcare Provider Details

I. General information

NPI: 1790221703
Provider Name (Legal Business Name): VALLEY HEALTHCARE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2017
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 W PUTNAM AVE
PORTERVILLE CA
93257-3257
US

IV. Provider business mailing address

590 W PUTNAM AVE SUITE 11
PORTERVILLE CA
93257-3257
US

V. Phone/Fax

Practice location:
  • Phone: 559-781-4100
  • Fax:
Mailing address:
  • Phone: 559-781-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN ANGELL
Title or Position: CFO
Credential:
Phone: 302-388-1588