MEDICARE: DR. LEE 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
1	207P00000X	Emergency Medicine Physician	MD017854E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265492987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEE VALENTINE M.D.

Provider Business Mailing Address
First Line	:	PO BOX 60041
Second Line	:
City	:	ARCADIA
State	:	CA
Zip	:	91066-6041
Country	:	US
Telephone Number	:	626-447-0296
Fax Number	:	626-447-6057

Provider Business Practice Location Address
First Line	:	508 S CHURCH ST
Second Line	:
City	:	MT PLEASANT
State	:	PA
Zip	:	15666-1702
Country	:	US
Telephone Number	:	724-832-4626
Fax Number	:	724-832-4668

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2006
Last Update Date	:	06/13/2008

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