Organization
VALLEY HEART ASSOCIATES MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN MERILLAT MD (PRESIDENT)
(209) 577-5557
Entity
Organization
Contact information
Practice address
1540 FLORIDA AVE, STE 100, MODESTO, CA 95350-4430
(209) 577-5557
(209) 579-7246
Mailing address
1540 FLORIDA AVE, STE 100, MODESTO, CA 95350-4430
(209) 577-5557
(209) 579-7246
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ76734Z
PTAN
CA
05
—
ZZZ76734Z
—
CA
Enumeration date
06/07/2006
Last updated
03/17/2015
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