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General NPI Number Information
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NPI Number | 1427039841
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Entity Type | Organization
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Legal Business Name | CORNING MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 11/11/2005
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 155 SOLANO ST
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City | CORNING
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State | CA
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Zip | 96021-3511
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Country | US
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Telephone | 530-824-4663
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Fax | 530-824-5204
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Provider Business Mailing Address
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Address Line | 155 SOLANO ST
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City | CORNING
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State | CA
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Zip | 96021-3511
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Country | US
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Telephone | 530-824-4663
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Fax | 530-824-5204
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. DON C MASSIE
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Credential | PAC
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Telephone | 530-824-4663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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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 #5
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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