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General NPI Number Information
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NPI Number | 1053614701
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Entity Type | Organization
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Legal Business Name | MADERA VALLEY PHYSICIANS ASSOCIATION
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Dates
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Enumeration Date | 12/17/2010
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Last Update Date | 12/17/2010
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Provider Practice Location Address
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Address Line | 1250 E ALMOND AVE
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City | MADERA
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State | CA
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Zip | 93637-5606
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Country | US
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Telephone | 559-675-5599
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Fax | 559-675-5598
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Provider Business Mailing Address
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Address Line | PO BOX 1246
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City | MADERA
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State | CA
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Zip | 93639-1246
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Country | US
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Telephone | 559-675-5599
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Fax | 559-675-5598
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Authorized Official
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Title or Position | IPA COORDINATOR
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Name | MS. BETTY R CATES
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Credential |
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Telephone | 559-675-5599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A31164
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License Number State | CA
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