Organization
CENTRAL VALLEY EYE MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVENS Y KIM MD (TREASURER)
(209) 952-3700
Entity
Organization
Contact information
Practice address
200 COTTAGE AVE, STE 102, MANTECA, CA 95336-4935
(209) 239-5303
(209) 239-0090
Mailing address
36 W YOKUTS AVE, STE 1, STOCKTON, CA 95207-5713
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0076150
—
CA
Enumeration date
04/04/2007
Last updated
10/08/2014
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