Valley Wide Medical Group Inc | |
12500 Boron Ave Boron CA 93730 | |
(760) 762-5111 | |
(760) 762-5695 |
Full Name | Valley Wide Medical Group Inc |
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Speciality | Family Medicine |
Location | 12500 Boron Ave, Boron, California |
Authorized Official Name and Position | Prabhakar Tummala (PRESIDENT) |
Authorized Official Contact | 9099457687 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Valley Wide Medical Group Inc 12500 Boron Ave Boron CA 93730 Ph: (760) 762-5111 | Valley Wide Medical Group Inc 12500 Boron Ave Boron CA 93730 Ph: (760) 762-5111 |
NPI Number | 1023295458 |
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Provider Enumeration Date | 01/29/2008 |
Last Update Date | 06/23/2008 |
Identifier | Type | State | Issuer |
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1023295458 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | A89858 (California) | Primary |