Provider Demographics
NPI:1174237135
Name:ERICK MADRIGAL, MD, MBA INC.
Entity type:Organization
Organization Name:ERICK MADRIGAL, MD, MBA INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEYVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-719-8108
Mailing Address - Street 1:222 W HENDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:PORTERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:93257-1731
Mailing Address - Country:US
Mailing Address - Phone:559-784-5483
Mailing Address - Fax:559-789-9828
Practice Address - Street 1:101 N PALM ST
Practice Address - Street 2:
Practice Address - City:WOODLAKE
Practice Address - State:CA
Practice Address - Zip Code:93286-1422
Practice Address - Country:US
Practice Address - Phone:559-564-1100
Practice Address - Fax:559-789-9828
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ERICK MADRIGAL, MD, MBA INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-01-12
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty