Green Valley Medical Corporation

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

GREEN VALLEY MEDICAL CORPORATION

Doing business as

Green Valley Medical Clinic

Practice address

41689 Road 128
Orosi, CA 93647-2060

Phone

(559) 528-1777

NPI assigned

Sep 9, 2010

Organization subpart

No

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

Authorized official

Name

Aurora Grace E Hwang, MD

Title

Medical Director

Phone

(559) 528-1777

Specialties & licenses 1

Addresses

Other names 1

• GREEN VALLEY MEDICAL CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Rural health clinic certification: CCN 058964

Legal name

GREEN VALLEY MEDICAL CORPORATION

Doing business as

GREEN VALLEY MEDICAL CLINIC

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Aug 23, 2011

Last certification

Mar 13, 2018

Ownership / control type

1B

Organization structure

CorporationProprietary

Incorporated

Aug 9, 2010 in CA

Enrollment address

41689 Road 128
Orosi, CA 93647-2060

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Aurora Grace E Hwang

  • Pediatrics Physician
  • Lindsay, CA
  • NPI 1821176587
  NPD (past)

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289779200000",
    "number": "1598072662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 SEQUOIA AVE",
            "city": "LINDSAY",
            "state": "CA",
            "postal_code": "932471424",
            "telephone_number": "559-528-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41689 ROAD 128",
            "city": "OROSI",
            "state": "CA",
            "postal_code": "936472060",
            "telephone_number": "559-528-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN VALLEY MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-09",
        "last_updated": "2010-11-15",
        "status": "A",
        "authorized_official_last_name": "HWANG",
        "authorized_official_first_name": "AURORA GRACE E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "559-528-1777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREEN VALLEY MEDICAL CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jonathan Garcia Martinez, M.S
• Jannette Garcia, NUTRITIONIST
• Jose Angel Garnica II, MS, PPS
• Javier Gomez
• Erika I Gonzalez-Delacruz, PPSC - 240063620
• Lizbeth Guzman Ruvalcaba
• Bradley Jay Hamann, PA-C
• David Heath, PA-C
• Isamar Hernandez-Ramos, PPS SCHOOL COUNSEL
• Vanessa Monique Howery, ASW104924

• Rural Health Clinic/Center in Orosi, CA
• Providers in Orosi, CA by specialty
• Rural Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.