| 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 |