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NPI Code Detail

MEDICARE: DAVID ALBERT VALENTINE M.D.

MEDICARE: DAVID ALBERT VALENTINE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician2025-00074NC
22084N0400XNeurology PhysicianMED-PHYS-LIC-113005MT
32084N0400XNeurology Physician169237CA
42084N0400XNeurology PhysicianDR.0066317CO

General Provider Information

NPI Number : 1093192486
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID ALBERT VALENTINE M.D.
Provider Business Mailing Address
First Line : 625 FAIR OAKS AVE STE 175
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-2683
Country : US
Telephone Number : 626-598-3770
Fax Number : 626-598-3797
Provider Business Practice Location Address
First Line : 625 FAIR OAKS AVE STE 175
Second Line :
City : SOUTH PASADENA
State : CA
Zip : 91030-2683
Country : US
Telephone Number : 626-598-3770
Fax Number : 626-598-3797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2015
Last Update Date : 05/16/2025

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