Provider Demographics
NPI:1740682319
Name:CENTRAL VALLEY PALLIATIVE MEDICINE INC
Entity type:Organization
Organization Name:CENTRAL VALLEY PALLIATIVE MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:L
Authorized Official - Last Name:COPELAND
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:559-284-7264
Mailing Address - Street 1:255 W HERNDON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0381
Mailing Address - Country:US
Mailing Address - Phone:559-570-0070
Mailing Address - Fax:559-570-0059
Practice Address - Street 1:7145 N CHESTNUT AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-0359
Practice Address - Country:US
Practice Address - Phone:559-284-7264
Practice Address - Fax:559-326-2170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-25
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10829207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty