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General NPI Number Information
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NPI Number | 1902871841
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Entity Type | Organization
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Legal Business Name | STARR-WOOD CARDIAC GROUP OF VISALIA MEDICAL CORPORATION, PC
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 100 WILLOW PLZ SUITE 301
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City | VISALIA
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State | CA
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Zip | 93291-6206
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Country | US
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Telephone | 559-734-3278
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Fax | 503-627-5723
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Provider Business Mailing Address
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Address Line | 4125 W NOBLE AVE PMB 323
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City | VISALIA
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State | CA
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Zip | 93277-1662
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Country | US
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Telephone | 559-734-3278
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Fax | 503-627-5723
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Authorized Official
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Title or Position | CARDIAC SERVICES
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Name | FREDERICK WILLIAM MAYER
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Credential | MD
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Telephone | 559-734-3278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | FNP23902
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License Number State | CA
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