Provider Demographics
NPI:1275745648
Name:VISALIA OBGYN MEDICAL ASSOCIATES INC
Entity Type:Organization
Organization Name:VISALIA OBGYN MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MORIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-627-9284
Mailing Address - Street 1:100 WILLOW PLZ
Mailing Address - Street 2:201
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6206
Mailing Address - Country:US
Mailing Address - Phone:559-627-9284
Mailing Address - Fax:559-713-0965
Practice Address - Street 1:100 WILLOW PLZ
Practice Address - Street 2:201
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-6206
Practice Address - Country:US
Practice Address - Phone:559-627-9284
Practice Address - Fax:559-713-0965
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-05
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0067850Medicaid
CAZZZ47930ZMedicare PIN