Organization
NORTH VALLEY UROLOGICAL MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY S. GARRETT M.D. (PRESIDENT OF CORPORATION)
(818) 365-9225
Entity
Organization
Contact information
Practice address
15545 SAN FERNANDO MISSION BLVD, STE A, MISSION HILLS, CA 91345-1346
(818) 365-9225
(818) 898-9678
Mailing address
15545 SAN FERNANDO MISSION BLVD, STE A, MISSION HILLS, CA 91345-1346
(818) 365-9225
(818) 898-9678
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ73068Z
—
CA
Enumeration date
12/20/2006
Last updated
08/22/2020
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