Active NPI
Valley Nephrology Medical Group
- Nephrology Physician
- Fresno, CA
National Provider Identifier
1063618296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- G13844
- Legal business name
- VALLEY NEPHROLOGY MEDICAL GROUP
- Practice address
- 1313 E Herndon Ave
Suite 105
Fresno, CA 93720-3306 - Phone
- (559) 448-8481
- Fax
- (559) 448-0996
- NPI assigned
- Jun 25, 2007
- Last updated
- Jan 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Leonor Q Garbutt
- Title
- Office Administrator
- Phone
- (559) 448-8481
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | G13844 | CA | Primary |
Addresses
Primary practice location
1313 E Herndon Ave
Suite 105
Fresno, CA 93720-3306
Mailing address
1313 E Herndon Ave
Suite 105
Fresno, CA 93720-3306
Phone (559) 448-8481
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G138440 | Medicaid | CA | |
| G13844 | Other | CA | STATE LICENSE |
| GR0023120 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
3845 N Clark St
Ste 103
Fresno, CA 93726
Phone (559) 227-8481
1313 E Herndon Ave
Ste 105
Fresno, CA 93720
Phone (559) 448-8481
1191 E Herndon Ave
Fresno, CA 93720
1115 W 4TH St Ste a
Madera, CA 93637
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Nephrology Physician
- Fresno, CA
- NPI 1063513737
-
- Nephrology Physician
- Fresno, CA
- NPI 1679539837
-
- Nephrology Physician
- Fresno, CA
- NPI 1043328545
-
- Nephrology Physician
- Fresno, CA
- NPI 1366744021
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182729600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1232064000000",
"number": "1063618296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1313 E HERNDON AVE",
"address_2": "SUITE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203306",
"telephone_number": "559-448-8481",
"fax_number": "559-448-0996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1313 E HERNDON AVE",
"address_2": "SUITE 105",
"city": "FRESNO",
"state": "CA",
"postal_code": "937203306",
"telephone_number": "559-448-8481",
"fax_number": "559-448-0996"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VALLEY NEPHROLOGY MEDICAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-25",
"last_updated": "2009-01-16",
"status": "A",
"authorized_official_last_name": "GARBUTT",
"authorized_official_first_name": "LEONOR",
"authorized_official_middle_name": "Q",
"authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
"authorized_official_telephone_number": "559-448-8481",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Nephrology",
"state": "CA",
"license": "G13844",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G138440",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "G13844",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0023120",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fresno, CA
- Valley Medical Systems, Inc. (Valley Home Care)
- Valley Medical Systems, Inc. (Valley Home Health)
- Valley Memory and Neuropsychology Center, a Psychological Corporation
- Valley Metabolic Imaging LLC
- Valley Natural Health, a Naturopathic Corporation
- Valley Nuclear Medical Group
- Valley Oak Oral Surgery and Dental Implant Group (Valley Oak Oral Surgery and Dental Implants)
- Valley Orthopedic Inc
- Valley Orthopedic Inc
- Valley Osteopathic Holistic Health Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.