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Contact Information

WILDWOOD MEDICAL, A MEDICAL CORP.
11244 PLEASANT VALLEY RD
PENN VALLEY, CA95946
 Phone: 530-432-4937
 Fax: 530-432-5261
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for WILDWOOD MEDICAL, A MEDICAL CORP.

NPI # 1013964220
LBN Legal business name WILDWOOD MEDICAL, A MEDICAL CORP.
Authorized official GINNY BACKUS - (BILLING CLERK)
Entity Organization
Organization subpart 1 No
Enumeration date 05/31/2006
Last updated 07/29/2009 - About 17 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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