Provider Demographics
NPI:1164768982
Name:O & D SURGICAL AND MEDICAL SOLUTIONS INC.
Entity Type:Organization
Organization Name:O & D SURGICAL AND MEDICAL SOLUTIONS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:JORGE
Authorized Official - Last Name:DEL VALLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-614-1445
Mailing Address - Street 1:140 EAST GRAGER AVENUE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-4347
Mailing Address - Country:US
Mailing Address - Phone:209-589-1500
Mailing Address - Fax:209-521-0813
Practice Address - Street 1:140 EAST GRAGER AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-4347
Practice Address - Country:US
Practice Address - Phone:209-589-1500
Practice Address - Fax:209-521-0813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA81970282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital