Organization
SOUTHERN TULARE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ATTOH MD (MD)
(559) 784-1110
Entity
Organization
Contact information
Practice address
465 W PUTNAM AVE, PORTERVILLE, CA 93257-3320
(559) 784-1110
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0095240
—
CA
01
—
ZZZ07552Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
01/31/2008
Last updated
01/31/2008
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