Provider Demographics
NPI:1215201884
Name:NORTH VALLEY MEDICAL CORPORATION
Entity Type:Organization
Organization Name:NORTH VALLEY MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-242-1415
Mailing Address - Street 1:473 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2105
Mailing Address - Country:US
Mailing Address - Phone:530-242-1415
Mailing Address - Fax:530-242-1473
Practice Address - Street 1:473 SOUTH ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2105
Practice Address - Country:US
Practice Address - Phone:530-242-1415
Practice Address - Fax:530-242-1473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty