Provider Demographics
NPI:1932641644
Name:OAK HILLS MEDICAL CORPORATION
Entity Type:Organization
Organization Name:OAK HILLS MEDICAL CORPORATION
Other - Org Name:DIABETIC FOOT AND WOUND CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:PROF
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:321-274-8344
Mailing Address - Street 1:PO BOX 748792 STE 106
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-8792
Mailing Address - Country:US
Mailing Address - Phone:661-324-4100
Mailing Address - Fax:661-324-4600
Practice Address - Street 1:714 MAIN ST
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-2953
Practice Address - Country:US
Practice Address - Phone:661-324-4100
Practice Address - Fax:661-324-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-11
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty