Provider Demographics
NPI:1033442942
Name:OAKVIEW MEDICAL GROUP A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:OAKVIEW MEDICAL GROUP A MEDICAL CORPORATION
Other - Org Name:OAKVIEW MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:T
Authorized Official - Last Name:FALAPPINO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:559-734-6700
Mailing Address - Street 1:1011 N. DEMAREE ST.
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5156
Mailing Address - Country:US
Mailing Address - Phone:559-734-6700
Mailing Address - Fax:559-734-6705
Practice Address - Street 1:1011 N. DEMAREE ST.
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5156
Practice Address - Country:US
Practice Address - Phone:559-734-6700
Practice Address - Fax:559-734-6705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-09
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A5221207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC3069163OtherCORPORATION
020A52211Medicare PIN