Organization
BI-VALLEY MEDICAL CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE JARVIE (VP, TREASURER)
(214) 379-3300
Entity
Organization
Contact information
Practice address
2100 CAPITOL AVE, SACRAMENTO, CA 95816-5721
(916) 442-4985
(916) 442-1029
Mailing address
1720 LAKEPOINTE DR STE 117, LEWISVILLE, TX 75057-6425
(143) 793-3002
(214) 853-9018
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
34-03
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMM70096F
MEDI-CAL
CA
01
—
GR0004550
MEDI-CAL
CA
Enumeration date
07/23/2006
Last updated
07/29/2024
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