Provider Demographics
NPI:1336956275
Name:CENTRAL VALLEY EMERGENCY MEDICINE
Entity type:Organization
Organization Name:CENTRAL VALLEY EMERGENCY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HARJOTH
Authorized Official - Middle Name:
Authorized Official - Last Name:MALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-450-5921
Mailing Address - Street 1:5211 W GOSHEN AVE
Mailing Address - Street 2:PMB 325
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-8619
Mailing Address - Country:US
Mailing Address - Phone:559-802-5596
Mailing Address - Fax:
Practice Address - Street 1:465 W PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-3320
Practice Address - Country:US
Practice Address - Phone:559-784-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Single Specialty