Provider Demographics
NPI:1215017629
Name:TRI-VALLEY PHYSICIANS
Entity Type:Organization
Organization Name:TRI-VALLEY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:YEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-463-0590
Mailing Address - Street 1:5575 W LAS POSITAS BLVD
Mailing Address - Street 2:#130
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588
Mailing Address - Country:US
Mailing Address - Phone:925-463-0590
Mailing Address - Fax:925-463-0708
Practice Address - Street 1:5575 W LAS POSITAS BLVD
Practice Address - Street 2:#130
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588
Practice Address - Country:US
Practice Address - Phone:925-463-0590
Practice Address - Fax:925-463-0708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0098400Medicaid
CAZZZ38748ZMedicare ID - Type Unspecified