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General NPI Number Information
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NPI Number | 1497096721
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Entity Type | Organization
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Legal Business Name | CENTRAL VALLEY MEDICAL SERVICES CORPORATION
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Dates
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Enumeration Date | 03/12/2013
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 2042 KERN ST
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City | FRESNO
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State | CA
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Zip | 93721-2008
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Country | US
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Telephone | 559-400-6420
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Fax |
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Provider Business Mailing Address
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Address Line | 2042 KERN ST
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City | FRESNO
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State | CA
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Zip | 93721-2008
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Country | US
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Telephone | 559-400-6420
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | IBRAHIM MAROUF
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Credential |
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Telephone | 949-228-5577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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