Unknown Individual – Obstetrics & Gynecology Physician, NPI 1710073531

Unknown Individual is a healthcare provider. based in Visalia, California. specializing in Obstetrics & Gynecology Physician. They hold a License No. C42028 (CA). The NPI Number for Unknown Individual is 1710073531

Main info

Organization
Inactive
56 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1710073531
Phone
(559) 737-4700
Address
305 EAST CENTER AVE
Deactivation Date
20 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5597817242
Graduation Year
1970 (56 years ago)
PAC ID
1153387527
Group Practice PAC ID
6305756339
Professional Enrollment ID
I20041207000972
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 305, East Center Avenue, Visalia, Tulare County, California, 93291, United States

    VISALIA, CA 932916331

    Phone: (559) 737-4700

    Fax: (559) 737-4782

    Type: Mailing

  • Family HealthCare Network, 1107, West Poplar Avenue, Porterville, Tulare County, California, 93257, United States

    PORTERVILLE, CA 932575839

    Phone: (559) 781-7242

    Fax: (760) 344-1410

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 93291)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305756339View full group profile
NameSpecialtyState
Physician AssistantCA
Family PracticeKY
Family PracticeCA
General SurgeryCA
-CA
-CA
General PracticeCA
General SurgeryCA
Nurse PractitionerCA
Family PracticeNY

Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1710073531 in the public NPI dataset.
Is Unknown Individual's NPI deactivated?
The extract indicates Unknown Individual is not in an active NPI state.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Visalia, California in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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Unknown Individual

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ANDREA B BOONE (M.D.)

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