Provider Demographics
NPI:1952417438
Name:VALLEY UROLOGY INC
Entity Type:Organization
Organization Name:VALLEY UROLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:GREG
Authorized Official - Last Name:RAINWATER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-438-2777
Mailing Address - Street 1:6113 N FRESNO ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5207
Mailing Address - Country:US
Mailing Address - Phone:559-438-2777
Mailing Address - Fax:559-438-4117
Practice Address - Street 1:6113 N FRESNO ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5207
Practice Address - Country:US
Practice Address - Phone:559-438-2777
Practice Address - Fax:559-438-4117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ02592ZMedicare UPIN