Provider Demographics
NPI:1942325808
Name:VALLEY INDUSTRIAL & FAMILY MEDICAL GROUP
Entity Type:Organization
Organization Name:VALLEY INDUSTRIAL & FAMILY MEDICAL GROUP
Other - Org Name:YES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER-CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:ALCOCER
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:559-627-3222
Mailing Address - Street 1:225 S CHINOWTH ST
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-5411
Mailing Address - Country:US
Mailing Address - Phone:559-627-3222
Mailing Address - Fax:559-627-9823
Practice Address - Street 1:225 S CHINOWTH ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5411
Practice Address - Country:US
Practice Address - Phone:559-627-3222
Practice Address - Fax:559-627-9823
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-20
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG21545146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, IntermediateGroup - Single Specialty