NPIMap

Organization Active NPI

Valley Associated Urology Medical Group Inc

  • Urology Physician
  • Oakdale, CA
National Provider Identifier
1972548246
Registry record updated Sep 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
VALLEY ASSOCIATED UROLOGY MEDICAL GROUP INC
Practice address
1415 W H St
Ste 1
Oakdale, CA 95361-3531
Phone
(209) 847-2554
Fax
(209) 847-2523
NPI assigned
Jun 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Authorized official

Name
Mr. Gerald Boyajian
Title
Chief Administrative Officer
Phone
(209) 521-0870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

1415 W H St
Ste 1
Oakdale, CA 95361-3531

Mailing address

1541 Florida Ave
Ste 306
Modesto, CA 95350-4429
Phone (209) 521-0870

Other identifiers 1

IdentifierTypeStateIssuer
GR0066265MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Valley Associated Urology Medical Group Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1972548246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 FLORIDA AVE",
            "address_2": "STE 306",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953504429",
            "telephone_number": "209-521-0870",
            "fax_number": "209-521-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 W H ST",
            "address_2": "STE 1",
            "city": "OAKDALE",
            "state": "CA",
            "postal_code": "953613531",
            "telephone_number": "209-847-2554",
            "fax_number": "209-847-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY ASSOCIATED UROLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "BOYAJIAN",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "209-521-0870",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0066265",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.