Provider Demographics
NPI:1942518832
Name:CENTRAL VALLEY MEDICAL SCHOLARSHIP FUND, INC.
Entity Type:Organization
Organization Name:CENTRAL VALLEY MEDICAL SCHOLARSHIP FUND, INC.
Other - Org Name:COMMUNITY GENERAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:O
Authorized Official - Last Name:PETTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-583-7535
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93656-0217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:319 MALL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5950
Practice Address - Country:US
Practice Address - Phone:559-583-7535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing