Provider Demographics
NPI:1508166190
Name:SOUTH VALLEY VASCULAR ASSOCIATES INC.
Entity Type:Organization
Organization Name:SOUTH VALLEY VASCULAR ASSOCIATES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:P
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-625-4118
Mailing Address - Street 1:PO BOX 7030
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93290-7030
Mailing Address - Country:US
Mailing Address - Phone:559-625-4118
Mailing Address - Fax:559-625-6004
Practice Address - Street 1:820 S. AKERS
Practice Address - Street 2:SUITE 120
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-5121
Practice Address - Country:US
Practice Address - Phone:559-625-4118
Practice Address - Fax:559-625-6004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-28
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty