Central Valley Ent Medical Group INC

NPI #1447369566 in Modesto, California

Provider Information

NPI Number: 1447369566
Entity Type: Organization
Organization Name: Central Valley Ent Medical Group INC
Primary Specialty: Specialist
Enumeration Date: Aug 30, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 1600 SUNRISE AVE
Address 2: SUITE 16
City: Modesto
State: California
ZIP Code: 95350-4679
Phone: (209) 524-6681

Authorized Official

Name: THOMAS EDWARD KILLEEN, M.D.
Title: PRESIDENT
Phone: (209) 524-6681

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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