# KAWEAH DELTA HEALTH CARE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kaweah Health Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619353042
- **Authorized official:** MALINDA TUPPER (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (596) 624-4065

## Contact information

- **Practice address:** 400 W MINERAL KING AVE, VISALIA, CA 93291-6237
- **Practice address phone:** (559) 624-5006
- **Practice address fax:** (559) 735-3006
- **Mailing address:** 400 W MINERAL KING AVE, VISALIA, CA 93291-6237
- **Mailing address phone:** (559) 624-5006

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/07/2015
- **Last updated:** 07/24/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CA171873 | MEDICARE PTAN | CA |