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General NPI Number Information
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NPI Number | 1194124586
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Entity Type | Organization
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Legal Business Name | CONCIERGE HEALTHCARE INC
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 805 W OAK AVE
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City | VISALIA
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State | CA
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Zip | 93291-6033
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Country | US
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Telephone | 559-732-4362
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Fax | 559-732-4911
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Provider Business Mailing Address
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Address Line | 805 W OAK AVE
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City | VISALIA
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State | CA
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Zip | 93291-6033
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Country | US
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Telephone | 559-732-4362
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Fax | 559-732-4911
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Authorized Official
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Title or Position | PA
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Name | JAIME SALVATIERRA
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Credential | PA
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Telephone | 559-732-4362
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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 | C25735
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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