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General NPI Number Information
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NPI Number | 1851448039
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Entity Type | Organization
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Legal Business Name | NAPA VALLEY UROLOGY ASSOCIATES A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 02/17/2016
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Provider Practice Location Address
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Address Line | 3250 BEARD RD
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City | NAPA
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State | CA
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Zip | 94558-3406
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Country | US
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Telephone | 707-224-7944
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Fax | 707-224-5220
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Provider Business Mailing Address
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Address Line | 3250 BEARD RD
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City | NAPA
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State | CA
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Zip | 94558-3406
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Country | US
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Telephone | 707-224-7944
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Fax | 707-224-5220
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES G HENDRICKS
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Credential | M.D.
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Telephone | 707-224-7944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C38117
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License Number State | CA
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