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General NPI Number Information
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NPI Number | 1265312995
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Entity Type | Organization
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Legal Business Name | VALLEY GASTROENTEROLOGY INSTITUTE
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Dates
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Enumeration Date | 09/04/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 2323 16TH ST STE 103
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City | BAKERSFIELD
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State | CA
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Zip | 93301-3453
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Country | US
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Telephone | 916-292-8938
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Fax | 916-938-2123
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Provider Business Mailing Address
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Address Line | 1191 E HERNDON AVE STE 103
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City | FRESNO
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State | CA
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Zip | 93720-3164
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Country | US
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Telephone | 916-292-8938
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Fax | 916-938-2123
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Authorized Official
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Title or Position | CEO
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Name | HONGTAO ALEX WANG
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Credential | MD
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Telephone | 916-292-8938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number |
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License Number State |
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