Provider Demographics
NPI:1922316538
Name:EDGAR O. VYHMEISTER, MD,
Entity Type:Organization
Organization Name:EDGAR O. VYHMEISTER, MD,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT ADMINISTRATOR/CPM
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-332-6021
Mailing Address - Street 1:1531 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3310
Mailing Address - Country:US
Mailing Address - Phone:530-332-4470
Mailing Address - Fax:530-893-6885
Practice Address - Street 1:265 COHASSET RD
Practice Address - Street 2:SUITE 170
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2273
Practice Address - Country:US
Practice Address - Phone:530-332-6021
Practice Address - Fax:530-893-6983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30543174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44460Medicare UPIN