Provider Demographics
NPI:1801221528
Name:SIVALINGAM MEDICAL CORPORATION, INC.
Entity Type:Organization
Organization Name:SIVALINGAM MEDICAL CORPORATION, INC.
Other - Org Name:FIRST VALLEY MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KANAGARATNAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SIVALINGAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:661-726-3724
Mailing Address - Street 1:44725 10TH ST W STE 170
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-3000
Mailing Address - Country:US
Mailing Address - Phone:661-726-3724
Mailing Address - Fax:661-726-3770
Practice Address - Street 1:44725 10TH ST W
Practice Address - Street 2:SUITE 280
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-3033
Practice Address - Country:US
Practice Address - Phone:661-726-3058
Practice Address - Fax:661-726-3723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-12
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA64159207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A641590Medicaid
CA00A641590Medicaid