Oak Valley Otolaryngology Inc

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

Legal business name

OAK VALLEY OTOLARYNGOLOGY INC

Practice address

250 S Oak Ave
Suite 4
Oakdale, CA 95361-3572

Phone

(209) 845-0100

Fax

(209) 845-0130

NPI assigned

Jun 22, 2011

Last updated

Aug 8, 2011By 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

Dr. Jerrold Polterock, MDNPI 1578536306

Title

MD/President

Phone

(209) 845-0100

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.

• Jerrold Polterock, MD

  • Otolaryngology Physician
  • Oakdale, CA
  • NPI 1578536306
  Authorized official Same address or phone

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1659667285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 S OAK AVE",
            "address_2": "SUITE 4",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953613572",
            "telephone_number": "209-845-0100",
            "fax_number": "209-845-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S OAK AVE",
            "address_2": "SUITE 4",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953613572",
            "telephone_number": "209-845-0100",
            "fax_number": "209-845-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK VALLEY OTOLARYNGOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "POLTEROCK",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_title_or_position": "MD/PRESIDENT",
        "authorized_official_telephone_number": "209-845-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oak Valley Hospital District (Oak Valley District Hospital Ambulance)
• Oak Valley Hospital District
• Oak Valley Hospital District (The Edge Occupational Medicine)
• Oak Valley Hospital District (Oakdale Community Health Center)
• Oak Valley Hospital District (Oak Valley Care Center)
• Oakdale Chiropractic Clinic
• Oakdale Kidney Center LLC (U.S. Renal Care Oakdale Dialysis)
• Oakdale Medical Group Inc
• Oakdale Pediatrics
• Oakdale Pharmacy

• Otolaryngology Physician in Oakdale, CA
• Providers in Oakdale, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; 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.