Ukiah Valley Primary Care Medical Group, Inc

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

A43219 Issued in CA

Legal business name

UKIAH VALLEY PRIMARY CARE MEDICAL GROUP, INC

Practice address

240 Hospital Dr Ste a
Ukiah, CA 95482-4558

Phone

(707) 463-8000

Fax

(707) 463-8006

NPI assigned

Aug 17, 2009

Organization subpart

No

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

Authorized official

Name

Darcie Anne Antle

Title

Administrator

Phone

(707) 463-8000

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250467200000",
    "number": "1902038573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2739",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954822739",
            "telephone_number": "707-463-8000",
            "fax_number": "707-463-8006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 HOSPITAL DR STE A",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824558",
            "telephone_number": "707-463-8000",
            "fax_number": "707-463-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UKIAH VALLEY PRIMARY CARE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-17",
        "last_updated": "2009-08-17",
        "status": "A",
        "authorized_official_last_name": "ANTLE",
        "authorized_official_first_name": "DARCIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "707-463-8000"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CA",
            "license": "A43219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A432190",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609874445",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ukiah Senior Center
• Ukiah Senior Center Inc.
• Ukiah Surgery Center LP
• Ukiah Valley Anesthesia Services
• Ukiah Valley Primary Care Medical Group, Inc
• Jason Don Ullyott, PA
• Melanie Ann Ulvila, LCSW
• Heylee Unangst
• Sabra Underwood
• United Holistic Health, a Professional Acupuncture Corporation

• Cardiovascular Disease Physician in Ukiah, CA
• Providers in Ukiah, CA by specialty
• Cardiovascular Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.