Healthcare Provider Details

I. General information

NPI: 1861321036
Provider Name (Legal Business Name): ATLAS VALLEY DERMATOLOGY MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1827 S COURT ST STE C
VISALIA CA
93277-5469
US

IV. Provider business mailing address

PO BOX 89
VISALIA CA
93279-0089
US

V. Phone/Fax

Practice location:
  • Phone: 559-529-2177
  • Fax: 559-468-0114
Mailing address:
  • Phone: 559-300-2628
  • Fax: 559-468-0114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: APRIL DAWN MATTHEWS
Title or Position: CFO
Credential: NP
Phone: 559-300-2628