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General NPI Number Information
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NPI Number | 1710590450
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Entity Type | Organization
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Legal Business Name | NAPA VALLEY INTERNAL MEDICINE
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Dates
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Enumeration Date | 08/24/2020
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Last Update Date | 10/16/2020
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Provider Practice Location Address
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Address Line | 999 ADAMS ST STE 201
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City | SAINT HELENA
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State | CA
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Zip | 94574-1149
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Country | US
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Telephone | 707-247-8921
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Fax |
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Provider Business Mailing Address
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Address Line | 40552 CHANTILLY CIR
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City | TEMECULA
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State | CA
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Zip | 92591-6967
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Country | US
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Telephone | 707-888-6155
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. NORMAN WALL
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Credential | DO
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Telephone | 707-888-6155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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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 | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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