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BIG VALLEY OB-GYN MEDICAL CENTERINC. NPI 1073619060


NPI Information

NPI: 1073619060
Provider Name: BIG VALLEY OB-GYN MEDICAL CENTER,INC.
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Organization
Address:
420 W ACACIA ST
SUITE 11
STOCKTON, CA
ZIP 95203
Phone: (209) 948-4098
Get Directions

BIG VALLEY OB-GYN MEDICAL CENTER,INC. is an obstetrics gynecology in Stockton, CA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. BIG VALLEY OB-GYN MEDICAL CENTER,INC. NPI is 1073619060. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

420 W ACACIA ST
SUITE 11
STOCKTON, CA
ZIP 95203-441
Phone: (209) 948-4098
Fax: (209) 948-2334

The provider's authorized official is Robert Charles Southmayd .
The authorized official title is Physician and has the following contact phone number (209) 948-4098.

The enumeration date for this NPI number is 9/16/2006 and was last updated on 8/26/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & Gynecology20A5298CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100AX52980MEDICAIDCALIFORNIA
202A52980MEDICARE PINCALIFORNIA
3E05424MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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