Provider Demographics
NPI:1841348448
Name:CENTRAL VALLEY COMPREHENSIVE CARE INC.
Entity type:Organization
Organization Name:CENTRAL VALLEY COMPREHENSIVE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:RIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:559-582-9313
Mailing Address - Street 1:869 W LACEY BLVD
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4328
Mailing Address - Country:US
Mailing Address - Phone:559-582-9313
Mailing Address - Fax:559-582-2570
Practice Address - Street 1:869 W LACEY BLVD
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4328
Practice Address - Country:US
Practice Address - Phone:559-582-9313
Practice Address - Fax:559-582-2570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty