Provider Demographics
NPI:1154873230
Name:VALLEY WOMEN'S HEALTHCARE MEDICAL GROUP, INC
Entity type:Organization
Organization Name:VALLEY WOMEN'S HEALTHCARE MEDICAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDLINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-860-0822
Mailing Address - Street 1:PO BOX 27890
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-7890
Mailing Address - Country:US
Mailing Address - Phone:559-244-0133
Mailing Address - Fax:559-477-4584
Practice Address - Street 1:5293 N 1ST ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7007
Practice Address - Country:US
Practice Address - Phone:559-244-0133
Practice Address - Fax:559-477-4584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty