Valley Wide Medical Group Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A89858 Issued in CA

Legal business name

VALLEY WIDE MEDICAL GROUP INC

Practice address

12500 Boron Ave
Boron, CA 93730

Phone

(760) 762-5111

Fax

(760) 762-5695

NPI assigned

Jan 29, 2008

Last updated

Jun 23, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Prabhakar Tummala, MDNPI 1780639344

Title

President

Phone

(909) 945-7687

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Prabhakar Tummala, MD

  • Emergency Medicine Physician
  • Boron, CA
  • NPI 1780639344
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1023295458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12500 BORON AVE",
            "city": "BORON",
            "state": "CA",
            "postal_code": "93730",
            "telephone_number": "760-762-5111",
            "fax_number": "760-762-5695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 BORON AVE",
            "city": "BORON",
            "state": "CA",
            "postal_code": "93730",
            "telephone_number": "760-762-5111",
            "fax_number": "760-762-5695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY WIDE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "TUMMALA",
        "authorized_official_first_name": "PRABHAKAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-945-7687",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A89858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 7 Hills Health Services
• Danielle Lynn Solis Salamanca
• Ross Edwin Swindlehurst, D.M.D.
• Prabhakar Tummala, MD
• Vetmobile Services Inc. (Medaide Medical)

• Family Medicine Physician in Boron, CA
• Providers in Boron, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.