1801837299 NPI number — VALLEY EMERGENCY MEDICAL ASSOCIATES

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801837299 NPI number — VALLEY EMERGENCY MEDICAL ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VALLEY EMERGENCY MEDICAL ASSOCIATES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801837299
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
444 EAST HUNTINGTON DRIVE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
ARCADIA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91006-3778
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-447-0296
Provider Business Mailing Address Fax Number:
626-447-6057

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14850 ROSCOE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PANORAMA CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91402-4618
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-904-3500
Provider Business Practice Location Address Fax Number:
818-904-3662
Provider Enumeration Date:
06/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EDWARDS
Authorized Official First Name:
IRV
Authorized Official Middle Name:
E
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
310-379-2134

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: GR0059330 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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