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General NPI Number Information
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NPI Number | 1194948562
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Entity Type | Organization
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Legal Business Name | VALLEY EAR NOSE AND ALLERGY GROUP
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 198 W CHERRY AVE SUITE A
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City | PORTERVILLE
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State | CA
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Zip | 93257-3506
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Country | US
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Telephone | 559-782-1871
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Fax | 559-782-1874
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Provider Business Mailing Address
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Address Line | 198 W CHERRY AVE SUITE A
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City | PORTERVILLE
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State | CA
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Zip | 93257-3506
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Country | US
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Telephone | 559-782-1871
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Fax | 559-782-1874
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Authorized Official
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Title or Position | OWNER
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Name | DR. DALE JACKSON COX
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Credential | M.D.
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Telephone | 559-782-1871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | G18002
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License Number State | CA
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