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General NPI Number Information
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NPI Number | 1598072662
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Entity Type | Organization
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Legal Business Name | GREEN VALLEY MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/09/2010
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Last Update Date | 11/15/2010
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Provider Practice Location Address
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Address Line | 41689 ROAD 128
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City | OROSI
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State | CA
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Zip | 93647-2060
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Country | US
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Telephone | 559-528-1777
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Fax |
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Provider Business Mailing Address
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Address Line | 835 SEQUOIA AVE
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City | LINDSAY
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State | CA
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Zip | 93247-1424
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Country | US
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Telephone | 559-528-1777
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | AURORA GRACE E HWANG
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Credential | MD
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Telephone | 559-528-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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