Provider Demographics
NPI:1396967295
Name:KAWEAH NEUROLOGICAL SURGERY ASSOCIATES
Entity type:Organization
Organization Name:KAWEAH NEUROLOGICAL SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-625-1054
Mailing Address - Street 1:501 S SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93292-2940
Mailing Address - Country:US
Mailing Address - Phone:559-625-1054
Mailing Address - Fax:559-625-1385
Practice Address - Street 1:501 S SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93292-2940
Practice Address - Country:US
Practice Address - Phone:559-625-1054
Practice Address - Fax:559-625-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G515050174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1578692141OtherINDIVIDUAL NPI
CA1184790784OtherINDIVIDUAL NPI
CA1184790784OtherINDIVIDUAL NPI
CA1578692141OtherINDIVIDUAL NPI