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General NPI Number Information
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NPI Number | 1669356218
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Entity Type | Organization
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Legal Business Name | EL CERRO PRIMARY CARE
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/05/2025
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Provider Practice Location Address
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Address Line | 5319 W HILLSDALE AVE
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City | VISALIA
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State | CA
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Zip | 93291-5118
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Country | US
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Telephone | 559-471-9803
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Fax |
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Provider Business Mailing Address
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Address Line | 5319 W HILLSDALE AVE
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City | VISALIA
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State | CA
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Zip | 93291-5118
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Country | US
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Telephone | 559-732-9900
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MATTHEW BETHANY
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Credential | DHA
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Telephone | 559-471-9803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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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 | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 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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