Healthcare Provider Details

I. General information

NPI: 1659531317
Provider Name (Legal Business Name): CENTRAL VALLEY GASTROENTEROLOGY ASSOCIATES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

981 E TUOLUMNE RD SUITE 106
TURLOCK CA
95382-1544
US

IV. Provider business mailing address

981 E TUOLUMNE RD SUITE 106
TURLOCK CA
95382-1544
US

V. Phone/Fax

Practice location:
  • Phone: 209-656-6800
  • Fax: 209-656-6828
Mailing address:
  • Phone: 209-656-6800
  • Fax: 209-656-6828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA102350
License Number StateCA

VIII. Authorized Official

Name: GURPREET SINGH
Title or Position: DOCTOR
Credential: M.D.
Phone: 732-895-9543