Provider Demographics
NPI:1164782777
Name:SIERRA VALLEY HEALTH CENTER INC
Entity Type:Organization
Organization Name:SIERRA VALLEY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANEETA
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-526-5770
Mailing Address - Street 1:1801 TULLY RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-2931
Mailing Address - Country:US
Mailing Address - Phone:209-526-5770
Mailing Address - Fax:209-544-1234
Practice Address - Street 1:1801 TULLY RD
Practice Address - Street 2:SUITE F
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-2931
Practice Address - Country:US
Practice Address - Phone:209-526-5770
Practice Address - Fax:209-544-1234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty