Provider Demographics
NPI:1982654604
Name:NORTH VALLEY FAMILY PHYSICIANS
Entity Type:Organization
Organization Name:NORTH VALLEY FAMILY PHYSICIANS
Other - Org Name:NORTH VALLEY FAMILY PHYSICIANS MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DELGADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-458-8050
Mailing Address - Street 1:173 E WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-2949
Mailing Address - Country:US
Mailing Address - Phone:530-458-8050
Mailing Address - Fax:530-458-5936
Practice Address - Street 1:173 E WEBSTER ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2949
Practice Address - Country:US
Practice Address - Phone:530-458-8050
Practice Address - Fax:530-458-5936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ20967ZMedicare UPIN