Organization
VALLEY NEPHROLOGY MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEONOR Q GARBUTT (OFFICE ADMINISTRATOR)
(559) 448-8481
Entity
Organization
Contact information
Practice address
1313 E HERNDON AVE, SUITE 105, FRESNO, CA 93720-3306
(559) 448-8481
(559) 448-0996
Mailing address
1313 E HERNDON AVE, SUITE 105, FRESNO, CA 93720-3306
(559) 448-8481
(559) 448-0996
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
G13844
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G138440
—
CA
01
—
G13844
STATE LICENSE
CA
05
—
GR0023120
—
CA
Enumeration date
06/25/2007
Last updated
01/16/2009
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