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VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC NPI 1225073588


NPI Information

NPI: 1225073588
Provider Name: VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Classification: Urology - 208800000X
Entity Type: Organization
Address:
200 COTTAGE AVE
STE 101
MANTECA, CA
ZIP 95336
Phone: (209) 239-2197
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VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC is an urology in Manteca, CA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC NPI is 1225073588. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

200 COTTAGE AVE
STE 101
MANTECA, CA
ZIP 95336-935
Phone: (209) 239-2197
Fax: (209) 239-7672

The provider's authorized official is Gerald Boyajian .
The authorized official title is Chief Administrative Officer and has the following contact phone number (209) 521-0870.

The enumeration date for this NPI number is 6/19/2006 and was last updated on 9/13/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrologyYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZZ00780ZMEDICARE PINCALIFORNIA
2GR0066264MEDICAIDCALIFORNIA

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: 4/28/2024

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