Provider Demographics
NPI:1265312995
Name:VALLEY GASTROENTEROLOGY INSTITUTE
Entity type:Organization
Organization Name:VALLEY GASTROENTEROLOGY INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HONGTAO
Authorized Official - Middle Name:ALEX
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-292-8938
Mailing Address - Street 1:1191 E HERNDON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3164
Mailing Address - Country:US
Mailing Address - Phone:916-292-8938
Mailing Address - Fax:916-938-2123
Practice Address - Street 1:2323 16TH ST STE 103
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3453
Practice Address - Country:US
Practice Address - Phone:916-292-8938
Practice Address - Fax:916-938-2123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric GastroenterologyGroup - Multi-Specialty