Provider Demographics
NPI:1144310657
Name:VALLEY HAND CENTER
Entity type:Organization
Organization Name:VALLEY HAND CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:AIMEE
Authorized Official - Last Name:SCHULLY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-575-2344
Mailing Address - Street 1:200 W ROSEBURG AVE
Mailing Address - Street 2:STE B-1
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-5200
Mailing Address - Country:US
Mailing Address - Phone:209-575-2344
Mailing Address - Fax:209-575-2340
Practice Address - Street 1:200 W ROSEBURG AVE
Practice Address - Street 2:STE B-1
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-5200
Practice Address - Country:US
Practice Address - Phone:209-575-2344
Practice Address - Fax:209-575-2340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG842150174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG61564Medicare UPIN