Central Valley Ent Medical Group Inc

LBN: Central Valley Ent Medical Group Inc
Central Valley Ent Medical Group Inc is an health care organization with primary practice located at 1600 Sunrise Ave Suite 16, Modesto CA 95350-4679. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Central Valley Ent Medical Group Inc can be contacted via phone (209) 524-6681, or through Killeen, Thomas Edward via phone (209) 524-6681.

Contact Information

Primary practice address
1600 Sunrise Ave Suite 16 Modesto CA 95350-4679
Fax: (209) 524-2962
Website:
Authorized official contact:
Name: Killeen, Thomas Edward Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1447369566
LBN Legal business name Central Valley Ent Medical Group Inc
DBA Doing business as
Authorized official Killeen, Thomas Edward Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 30th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447369566 NPPES
California MEDICAID ZZZ73209Z

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