Provider Demographics
NPI:1295481968
Name:VALLEY PACIFIC A MEDICAL CORPORATION
Entity type:Organization
Organization Name:VALLEY PACIFIC A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLBY
Authorized Official - Middle Name:R
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:559-216-0407
Mailing Address - Street 1:PO BOX 25042
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-5042
Mailing Address - Country:US
Mailing Address - Phone:559-892-4500
Mailing Address - Fax:559-892-4550
Practice Address - Street 1:7055 N CHESTNUT AVE STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0350
Practice Address - Country:US
Practice Address - Phone:559-216-0407
Practice Address - Fax:559-892-4550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty