| Valley Wide Medical Group Inc | |
| 
					12500 Boron Ave Boron CA 93730  | |
| (760) 762-5111 | |
| (760) 762-5695 | 
| Full Name | Valley Wide Medical Group Inc | 
|---|---|
| Speciality | Family Medicine | 
| Location | 12500 Boron Ave, Boron, California | 
| Authorized Official Name and Position | Prabhakar Tummala (PRESIDENT) | 
| Authorized Official Contact | 9099457687 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Valley Wide Medical Group Inc 12500 Boron Ave Boron CA 93730 Ph: (760) 762-5111  | Valley Wide Medical Group Inc 12500 Boron Ave Boron CA 93730 Ph: (760) 762-5111  | 
| NPI Number | 1023295458 | 
|---|---|
| Provider Enumeration Date | 01/29/2008 | 
| Last Update Date | 06/23/2008 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1023295458 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | A89858 (California) | Primary |