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VALLEY NEPHROLOGY MEDICAL GROUP NPI 1063618296


NPI Information

NPI: 1063618296
Provider Name: VALLEY NEPHROLOGY MEDICAL GROUP
Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

Address:
1313 E HERNDON AVE
SUITE 105
FRESNO, CA
ZIP 93720
Phone: (559) 448-8481
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VALLEY NEPHROLOGY MEDICAL GROUP is a nephrology internal medicine in Fresno, CA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. VALLEY NEPHROLOGY MEDICAL GROUP NPI is 1063618296. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1313 E HERNDON AVE
SUITE 105
FRESNO, CA
ZIP 93720-306
Phone: (559) 448-8481
Fax: (559) 448-0996

The provider's authorized official is Leonor Q Garbutt .
The authorized official title is Office Administrator and has the following contact phone number (559) 448-8481.

The enumeration date for this NPI number is 6/25/2007 and was last updated on 1/16/2009.


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
1207RN0300XInternal MedicineNephrologyG13844CALIFORNIAYes

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
1GR0023120MEDICAIDCALIFORNIA
200G138440MEDICARE PINCALIFORNIA
3G13844OTHERCALIFORNIASTATE LICENSE
4A39103MEDICARE UPINCALIFORNIA
500G138442MEDICARE PINCALIFORNIA
6ZZZ99970ZMEDICARE PINCALIFORNIA
700G138440MEDICAIDCALIFORNIA

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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