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General NPI Number Information
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NPI Number | 1073764254
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Entity Type | Organization
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Legal Business Name | SIERRA VIEW FAMILY CLINIC INC
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 05/09/2016
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Provider Practice Location Address
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Address Line | 1237 ROSE AVE
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City | SELMA
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State | CA
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Zip | 93662-3227
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Country | US
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Telephone | 559-898-0935
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Fax | 559-898-0939
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Provider Business Mailing Address
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Address Line | PO BOX 450
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City | HANFORD
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State | CA
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Zip | 93232-0450
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Country | US
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Telephone | 559-898-0935
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Fax | 559-898-0939
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Authorized Official
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Title or Position | PRESIDENT MD
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Name | HUMBERTO JESUS VILLALVAZO
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Credential | MD
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Telephone | 559-898-0935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A89926
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License Number State | CA
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